Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,724.08 / $1,724.08 / $1,724.08	Facility		$1,724.08	$1,724.08	$1,724.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,436.73 / $1,724.08 / $1,724.08	Professional		$1,436.73	$1,724.08	$1,724.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,569.34 / $9,103.89 / $16,581.16	Facility		$4,569.34	$9,103.89	$16,581.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,867.98 / $3,018.93 / $4,075.56	Professional		$2,867.98	$3,018.93	$4,075.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,915.26 / $1,962.30 / $1,972.93	Facility		$1,915.26	$1,962.30	$1,972.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,415.14 / $2,415.14 / $2,415.14	Professional		$2,415.14	$2,415.14	$2,415.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,952.91 / $1,952.91 / $1,952.91	Facility		$1,952.91	$1,952.91	$1,952.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,952.91 / $1,952.91 / $3,499.88	Professional		$1,952.91	$1,952.91	$3,499.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,724.08 / $2,181.62 / $2,181.62	Facility		$1,724.08	$2,181.62	$2,181.62
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,724.08 / $2,181.62 / $3,395.52	Professional		$1,724.08	$2,181.62	$3,395.52
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 $1,121.21 / $1,443.24 / $2,160.69	Professional		$1,121.21	$1,443.24	$2,160.69