Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,242.64 / $2,242.64 / $2,242.64	Facility		$2,242.64	$2,242.64	$2,242.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,868.87 / $2,242.64 / $2,242.64	Professional		$1,868.87	$2,242.64	$2,242.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,943.68 / $11,842.11 / $21,568.38	Facility		$5,943.68	$11,842.11	$21,568.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,730.60 / $3,926.95 / $5,301.38	Professional		$3,730.60	$3,926.95	$5,301.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,491.32 / $2,552.52 / $2,566.33	Facility		$2,491.32	$2,552.52	$2,566.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,141.56 / $3,141.56 / $3,141.56	Professional		$3,141.56	$3,141.56	$3,141.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,540.30 / $2,540.30 / $2,540.30	Facility		$2,540.30	$2,540.30	$2,540.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,540.30 / $2,540.30 / $4,552.50	Professional		$2,540.30	$2,540.30	$4,552.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,242.64 / $2,837.79 / $2,837.79	Facility		$2,242.64	$2,837.79	$2,837.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,242.64 / $2,837.79 / $4,416.81	Professional		$2,242.64	$2,837.79	$4,416.81
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 $1,458.44 / $1,877.33 / $2,775.68	Professional		$1,458.44	$1,877.33	$2,775.68