Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,169.02 / $1,169.02 / $1,169.02	Facility		$1,169.02	$1,169.02	$1,169.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $837.35 / $1,169.02 / $1,169.02	Professional		$837.35	$1,169.02	$1,169.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,098.26 / $6,172.93 / $11,242.94	Facility		$3,098.26	$6,172.93	$11,242.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,944.65 / $2,047.00 / $2,763.45	Professional		$1,944.65	$2,047.00	$2,763.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,073.74 / $1,180.75 / $1,330.55	Facility		$1,073.74	$1,180.75	$1,330.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,637.60 / $1,637.60 / $1,637.60	Professional		$1,637.60	$1,637.60	$1,637.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,324.18 / $1,324.18 / $1,324.18	Facility		$1,324.18	$1,324.18	$1,324.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,324.18 / $1,324.18 / $2,373.00	Professional		$1,324.18	$1,324.18	$2,373.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,169.02 / $1,479.25 / $1,479.25	Facility		$1,169.02	$1,479.25	$1,479.25
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,169.02 / $1,479.25 / $2,302.34	Professional		$1,169.02	$1,479.25	$2,302.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $592.40	Professional		$30.00	$30.00	$592.40
United Facility/Professional Facility Modifier Low / Median / High Price $640.00 / $640.00 / $640.00	Facility		$640.00	$640.00	$640.00
United Facility/Professional Professional Modifier Low / Median / High Price $686.77 / $978.59 / $1,367.75	Professional		$686.77	$978.59	$1,367.75