Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,174.44 / $2,174.44 / $2,174.44	Facility		$2,174.44	$2,174.44	$2,174.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,812.04 / $2,174.44 / $2,174.44	Professional		$1,812.04	$2,174.44	$2,174.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,762.96 / $11,482.05 / $20,912.59	Facility		$5,762.96	$11,482.05	$20,912.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,617.17 / $3,807.55 / $5,140.18	Professional		$3,617.17	$3,807.55	$5,140.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,415.58 / $2,474.91 / $2,488.32	Facility		$2,415.58	$2,474.91	$2,488.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,046.04 / $3,046.04 / $3,046.04	Professional		$3,046.04	$3,046.04	$3,046.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,463.07 / $2,463.07 / $2,463.07	Facility		$2,463.07	$2,463.07	$2,463.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,463.07 / $2,463.07 / $4,414.13	Professional		$2,463.07	$2,463.07	$4,414.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,174.44 / $2,751.51 / $2,751.51	Facility		$2,174.44	$2,751.51	$2,751.51
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,154.38 / $2,751.51 / $3,997.92	Professional		$2,154.38	$2,751.51	$3,997.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,394.95 / $2,817.59 / $3,240.22	Professional		$2,394.95	$2,817.59	$3,240.22
United Facility/Professional Professional Modifier Low / Median / High Price $1,414.09 / $1,820.26 / $2,691.29	Professional		$1,414.09	$1,820.26	$2,691.29