Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,107.91 / $1,107.91 / $1,107.91	Facility		$1,107.91	$1,107.91	$1,107.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $942.90 / $1,107.91 / $1,107.91	Professional		$942.90	$1,107.91	$1,107.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,936.29 / $5,850.23 / $10,655.20	Facility		$2,936.29	$5,850.23	$10,655.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,842.99 / $1,939.99 / $2,618.98	Professional		$1,842.99	$1,939.99	$2,618.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,260.99 / $1,260.99 / $1,260.99	Facility		$1,260.99	$1,260.99	$1,260.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,551.99 / $1,551.99 / $1,551.99	Professional		$1,551.99	$1,551.99	$1,551.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,254.96 / $1,254.96 / $1,254.96	Facility		$1,254.96	$1,254.96	$1,254.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,254.96 / $1,254.96 / $2,248.88	Professional		$1,254.96	$1,254.96	$2,248.88
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,107.91 / $1,401.93 / $1,401.93	Facility		$1,107.91	$1,401.93	$1,401.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,107.91 / $1,401.93 / $2,181.98	Professional		$1,107.91	$1,401.93	$2,181.98
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 Facility Modifier Low / Median / High Price $969.63 / $969.63 / $969.63	Facility		$969.63	$969.63	$969.63
United Facility/Professional Professional Modifier Low / Median / High Price $806.53 / $967.84 / $1,491.41	Professional		$806.53	$967.84	$1,491.41