Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,542.43 / $1,542.43 / $1,542.43	Facility		$1,542.43	$1,542.43	$1,542.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,210.58 / $1,542.43 / $1,542.43	Professional		$1,210.58	$1,542.43	$1,542.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,087.91 / $8,144.68 / $14,834.15	Facility		$4,087.91	$8,144.68	$14,834.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,565.81 / $2,700.85 / $3,646.15	Professional		$2,565.81	$2,700.85	$3,646.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,521.49 / $1,732.91 / $1,755.55	Facility		$1,521.49	$1,732.91	$1,755.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,160.67 / $2,160.67 / $2,160.67	Professional		$2,160.67	$2,160.67	$2,160.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,747.16 / $1,747.16 / $1,747.16	Facility		$1,747.16	$1,747.16	$1,747.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,747.16 / $1,747.16 / $3,131.25	Professional		$1,747.16	$1,747.16	$3,131.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,542.43 / $1,951.76 / $1,951.76	Facility		$1,542.43	$1,951.76	$1,951.76
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,542.43 / $1,951.76 / $3,037.77	Professional		$1,542.43	$1,951.76	$3,037.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $939.81 / $1,291.18 / $1,804.64	Professional		$939.81	$1,291.18	$1,804.64