Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.52 / $1,621.52 / $1,621.52	Facility		$1,621.52	$1,621.52	$1,621.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,351.27 / $1,621.52 / $1,621.52	Professional		$1,351.27	$1,621.52	$1,621.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,297.55 / $8,562.37 / $15,594.90	Facility		$4,297.55	$8,562.37	$15,594.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,697.39 / $2,839.36 / $3,833.14	Professional		$2,697.39	$2,839.36	$3,833.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,801.31 / $1,845.58 / $1,855.57	Facility		$1,801.31	$1,845.58	$1,855.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,271.48 / $2,271.48 / $2,271.48	Professional		$2,271.48	$2,271.48	$2,271.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,584.92 / $1,584.92 / $1,584.92	Facility		$1,584.92	$1,584.92	$1,584.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,435.65 / $1,584.92 / $3,291.75	Professional		$1,435.65	$1,584.92	$3,291.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,621.52 / $2,051.84 / $2,051.84	Facility		$1,621.52	$2,051.84	$2,051.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,606.55 / $2,051.84 / $2,981.32	Professional		$1,606.55	$2,051.84	$2,981.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,785.96 / $2,101.13 / $2,416.29	Professional		$1,785.96	$2,101.13	$2,416.29
United Facility/Professional Professional Modifier Low / Median / High Price $1,054.51 / $1,357.39 / $2,109.01	Professional		$1,054.51	$1,357.39	$2,109.01