Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,456.51 / $2,456.51 / $2,456.51	Facility		$2,456.51	$2,456.51	$2,456.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,036.10 / $2,456.51 / $2,456.51	Professional		$2,036.10	$2,456.51	$2,456.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,510.53 / $12,971.48 / $23,625.34	Facility		$6,510.53	$12,971.48	$23,625.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,086.39 / $4,301.46 / $5,806.97	Professional		$4,086.39	$4,301.46	$5,806.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,277.01 / $2,511.64 / $2,795.95	Facility		$2,277.01	$2,511.64	$2,795.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,441.17 / $3,441.17 / $3,441.17	Professional		$3,441.17	$3,441.17	$3,441.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,782.58 / $2,782.58 / $2,782.58	Facility		$2,782.58	$2,782.58	$2,782.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,031.28 / $3,576.58 / $6,233.44	Professional		$2,031.28	$3,576.58	$6,233.44
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,456.51 / $3,108.45 / $3,108.45	Facility		$2,456.51	$3,108.45	$3,108.45
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,456.51 / $3,108.45 / $4,838.04	Professional		$2,456.51	$3,108.45	$4,838.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $1,391.85	Professional		$30.00	$30.00	$1,391.85
United Facility/Professional Professional Modifier Low / Median / High Price $1,410.40 / $2,056.37 / $2,874.13	Professional		$1,410.40	$2,056.37	$2,874.13