Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,162.35 / $1,162.35 / $1,162.35	Facility		$1,162.35	$1,162.35	$1,162.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $920.81 / $1,162.35 / $1,162.35	Professional		$920.81	$1,162.35	$1,162.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,080.61 / $6,137.77 / $11,178.90	Facility		$3,080.61	$6,137.77	$11,178.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,933.57 / $2,035.34 / $2,747.71	Professional		$1,933.57	$2,035.34	$2,747.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,220.59 / $1,322.97 / $1,433.63	Facility		$1,220.59	$1,322.97	$1,433.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,628.27 / $1,628.27 / $1,628.27	Professional		$1,628.27	$1,628.27	$1,628.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,316.65 / $1,316.65 / $1,316.65	Facility		$1,316.65	$1,316.65	$1,316.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,316.65 / $1,316.65 / $2,359.50	Professional		$1,316.65	$1,316.65	$2,359.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,162.35 / $1,470.84 / $1,470.84	Facility		$1,162.35	$1,470.84	$1,470.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,162.35 / $1,470.84 / $2,289.25	Professional		$1,162.35	$1,470.84	$2,289.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $700.43	Professional		$30.00	$30.00	$700.43
United Facility/Professional Professional Modifier Low / Median / High Price $738.84 / $973.03 / $1,456.74	Professional		$738.84	$973.03	$1,456.74