Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,138.01 / $2,138.01 / $2,138.01	Facility		$2,138.01	$2,138.01	$2,138.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,781.68 / $2,138.01 / $2,138.01	Professional		$1,781.68	$2,138.01	$2,138.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,666.39 / $11,289.62 / $20,562.12	Facility		$5,666.39	$11,289.62	$20,562.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,556.55 / $3,743.74 / $5,054.05	Professional		$3,556.55	$3,743.74	$5,054.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,375.09 / $2,433.42 / $2,446.63	Facility		$2,375.09	$2,433.42	$2,446.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,994.99 / $2,994.99 / $2,994.99	Professional		$2,994.99	$2,994.99	$2,994.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,264.80 / $2,264.80 / $2,264.80	Facility		$2,264.80	$2,264.80	$2,264.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,264.80 / $2,264.80 / $4,340.25	Professional		$2,264.80	$2,264.80	$4,340.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,138.01 / $2,705.40 / $2,705.40	Facility		$2,138.01	$2,705.40	$2,705.40
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,138.01 / $2,705.40 / $4,210.76	Professional		$2,138.01	$2,705.40	$4,210.76
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 $1,390.40 / $1,789.75 / $2,646.19	Professional		$1,390.40	$1,789.75	$2,646.19