Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,391.91 / $1,391.91 / $1,391.91	Facility		$1,391.91	$1,391.91	$1,391.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $950.53 / $1,391.91 / $1,391.91	Professional		$950.53	$1,391.91	$1,391.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,688.99 / $7,349.89 / $13,386.57	Facility		$3,688.99	$7,349.89	$13,386.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,315.42 / $2,437.29 / $3,290.34	Professional		$2,315.42	$2,437.29	$3,290.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,259.99 / $1,303.65 / $1,584.24	Facility		$1,259.99	$1,303.65	$1,584.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,949.83 / $1,949.83 / $1,949.83	Professional		$1,949.83	$1,949.83	$1,949.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,576.65 / $1,576.65 / $1,576.65	Facility		$1,576.65	$1,576.65	$1,576.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,576.65 / $1,576.65 / $2,825.63	Professional		$1,576.65	$1,576.65	$2,825.63
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,391.91 / $1,761.30 / $1,761.30	Facility		$1,391.91	$1,761.30	$1,761.30
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,391.91 / $1,761.30 / $2,741.34	Professional		$1,391.91	$1,761.30	$2,741.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $769.24	Professional		$30.00	$30.00	$769.24
United Facility/Professional Professional Modifier Low / Median / High Price $780.00 / $1,165.18 / $1,628.52	Professional		$780.00	$1,165.18	$1,628.52