Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,021.82 / $1,021.82 / $1,021.82	Facility		$1,021.82	$1,021.82	$1,021.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $840.35 / $1,021.82 / $1,021.82	Professional		$840.35	$1,021.82	$1,021.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,708.16 / $5,395.69 / $9,827.33	Facility		$2,708.16	$5,395.69	$9,827.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,699.80 / $1,789.26 / $2,415.50	Professional		$1,699.80	$1,789.26	$2,415.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,003.34 / $1,147.27 / $1,163.02	Facility		$1,003.34	$1,147.27	$1,163.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,431.41 / $1,431.41 / $1,431.41	Professional		$1,431.41	$1,431.41	$1,431.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,260.83 / $1,260.83 / $1,260.83	Facility		$1,260.83	$1,260.83	$1,260.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,260.83 / $1,260.83 / $2,074.13	Professional		$1,260.83	$1,260.83	$2,074.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,021.82 / $1,292.99 / $1,292.99	Facility		$1,021.82	$1,292.99	$1,292.99
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,021.82 / $1,292.99 / $2,012.45	Professional		$1,021.82	$1,292.99	$2,012.45
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 $641.74 / $855.37 / $1,280.58	Professional		$641.74	$855.37	$1,280.58