Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,596.42 / $2,596.42 / $2,596.42	Facility		$2,596.42	$2,596.42	$2,596.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,163.69 / $2,596.42 / $2,596.42	Professional		$2,163.69	$2,596.42	$2,596.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,881.35 / $13,710.30 / $24,970.98	Facility		$6,881.35	$13,710.30	$24,970.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,319.14 / $4,546.46 / $6,137.72	Professional		$4,319.14	$4,546.46	$6,137.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,884.39 / $2,955.20 / $2,971.20	Facility		$2,884.39	$2,955.20	$2,971.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,637.17 / $3,637.17 / $3,637.17	Professional		$3,637.17	$3,637.17	$3,637.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,941.06 / $2,941.06 / $2,941.06	Facility		$2,941.06	$2,941.06	$2,941.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,146.96 / $3,780.30 / $6,588.28	Professional		$2,146.96	$3,780.30	$6,588.28
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,596.42 / $3,285.49 / $3,285.49	Facility		$2,596.42	$3,285.49	$3,285.49
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,596.42 / $3,285.49 / $5,113.60	Professional		$2,596.42	$3,285.49	$5,113.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,859.72 / $3,364.38 / $3,869.03	Professional		$2,859.72	$3,364.38	$3,869.03
United Facility/Professional Professional Modifier Low / Median / High Price $1,688.53 / $2,173.50 / $3,254.00	Professional		$1,688.53	$2,173.50	$3,254.00