Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,096.98 / $2,096.98 / $2,096.98	Facility		$2,096.98	$2,096.98	$2,096.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,712.11 / $2,096.98 / $2,096.98	Professional		$1,712.11	$2,096.98	$2,096.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,557.66 / $11,073.01 / $20,167.59	Facility		$5,557.66	$11,073.01	$20,167.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,488.31 / $3,671.91 / $4,957.08	Professional		$3,488.31	$3,671.91	$4,957.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,199.40 / $2,269.52 / $2,386.73	Facility		$2,199.40	$2,269.52	$2,386.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,937.53 / $2,937.53 / $2,937.53	Professional		$2,937.53	$2,937.53	$2,937.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,375.33 / $2,375.33 / $2,375.33	Facility		$2,375.33	$2,375.33	$2,375.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,375.32 / $2,375.33 / $4,257.00	Professional		$2,375.32	$2,375.33	$4,257.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,096.98 / $2,653.50 / $2,653.50	Facility		$2,096.98	$2,653.50	$2,653.50
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,096.98 / $2,653.50 / $4,129.96	Professional		$2,096.98	$2,653.50	$4,129.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,309.62 / $2,717.21 / $3,124.79	Professional		$2,309.62	$2,717.21	$3,124.79
United Facility/Professional Facility Modifier Low / Median / High Price $3,834.85 / $4,511.59 / $4,511.59	Facility		$3,834.85	$4,511.59	$4,511.59
United Facility/Professional Professional Modifier Low / Median / High Price $1,406.74 / $1,755.41 / $2,628.07	Professional		$1,406.74	$1,755.41	$2,628.07