Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,576.36 / $2,576.36 / $2,576.36	Facility		$2,576.36	$2,576.36	$2,576.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,182.94 / $2,576.36 / $2,576.36	Professional		$2,182.94	$2,576.36	$2,576.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,828.14 / $13,604.28 / $24,777.86	Facility		$6,828.14	$13,604.28	$24,777.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,285.74 / $4,511.30 / $6,090.26	Professional		$4,285.74	$4,511.30	$6,090.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,739.11 / $2,893.66 / $2,932.35	Facility		$2,739.11	$2,893.66	$2,932.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3,609.04 / $3,609.04 / $3,609.04	Professional		$3,609.04	$3,609.04	$3,609.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,741.63 / $2,741.63 / $2,741.63	Facility		$2,741.63	$2,741.63	$2,741.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,741.63 / $2,741.63 / $5,230.13	Professional		$2,741.63	$2,741.63	$5,230.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,576.36 / $3,260.08 / $3,260.08	Facility		$2,576.36	$3,260.08	$3,260.08
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,576.36 / $3,260.08 / $5,074.07	Professional		$2,576.36	$3,260.08	$5,074.07
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 $1,751.94 / $2,156.69 / $3,239.62	Professional		$1,751.94	$2,156.69	$3,239.62