Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,576.93 / $1,576.93 / $1,576.93	Facility		$1,576.93	$1,576.93	$1,576.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,314.11 / $1,576.93 / $1,576.93	Professional		$1,314.11	$1,576.93	$1,576.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,179.35 / $8,326.89 / $15,166.00	Facility		$4,179.35	$8,326.89	$15,166.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,623.21 / $2,761.27 / $3,727.71	Professional		$2,623.21	$2,761.27	$3,727.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,751.80 / $1,794.83 / $1,804.52	Facility		$1,751.80	$1,794.83	$1,804.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,209.02 / $2,209.02 / $2,209.02	Professional		$2,209.02	$2,209.02	$2,209.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,786.24 / $1,786.24 / $1,786.24	Facility		$1,786.24	$1,786.24	$1,786.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,786.24 / $1,786.24 / $3,201.00	Professional		$1,786.24	$1,786.24	$3,201.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,576.93 / $1,995.42 / $1,995.42	Facility		$1,576.93	$1,995.42	$1,995.42
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,576.93 / $1,995.42 / $3,105.73	Professional		$1,576.93	$1,995.42	$3,105.73
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 $1,025.52 / $1,320.07 / $1,896.34	Professional		$1,025.52	$1,320.07	$1,896.34