Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,323.26 / $1,323.26 / $1,323.26	Facility		$1,323.26	$1,323.26	$1,323.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $928.30 / $1,323.26 / $1,323.26	Professional		$928.30	$1,323.26	$1,323.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,317.09 / $2,317.09 / $2,317.09	Professional		$2,317.09	$2,317.09	$2,317.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,507.06 / $6,987.42 / $12,726.39	Facility		$3,507.06	$6,987.42	$12,726.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,201.23 / $2,317.09 / $3,128.07	Professional		$2,201.23	$2,317.09	$3,128.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,230.52 / $1,385.14 / $1,506.11	Facility		$1,230.52	$1,385.14	$1,506.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,853.67 / $1,853.67 / $1,853.67	Professional		$1,853.67	$1,853.67	$1,853.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,498.90 / $1,498.90 / $1,498.90	Facility		$1,498.90	$1,498.90	$1,498.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,498.90 / $1,498.90 / $2,686.13	Professional		$1,498.90	$1,498.90	$2,686.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,323.26 / $1,674.44 / $1,674.44	Facility		$1,323.26	$1,674.44	$1,674.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,323.26 / $1,674.44 / $2,462.00	Professional		$1,323.26	$1,674.44	$2,462.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $842.61	Professional		$30.00	$30.00	$842.61
United Facility/Professional Professional Modifier Low / Median / High Price $732.62 / $1,107.72 / $1,541.30	Professional		$732.62	$1,107.72	$1,541.30