Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,731.00 / $1,731.00 / $1,731.00	Facility		$1,731.00	$1,731.00	$1,731.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,384.88 / $1,731.00 / $1,731.00	Professional		$1,384.88	$1,731.00	$1,731.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,587.68 / $9,140.43 / $16,647.74	Facility		$4,587.68	$9,140.43	$16,647.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,879.50 / $3,031.05 / $4,091.92	Professional		$2,879.50	$3,031.05	$4,091.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,739.27 / $1,851.73 / $1,970.18	Facility		$1,739.27	$1,851.73	$1,970.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,424.84 / $2,424.84 / $2,424.84	Professional		$2,424.84	$2,424.84	$2,424.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,960.76 / $1,960.76 / $1,960.76	Facility		$1,960.76	$1,960.76	$1,960.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,960.76 / $1,960.76 / $3,513.75	Professional		$1,960.76	$1,960.76	$3,513.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,731.00 / $2,190.37 / $2,190.37	Facility		$1,731.00	$2,190.37	$2,190.37
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,731.00 / $2,190.37 / $3,409.16	Professional		$1,731.00	$2,190.37	$3,409.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $961.76	Professional		$30.00	$30.00	$961.76
United Facility/Professional Professional Modifier Low / Median / High Price $1,107.72 / $1,423.39 / $2,169.38	Professional		$1,107.72	$1,423.39	$2,169.38