Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,359.89 / $4,359.89 / $4,359.89	Facility		$4,359.89	$4,359.89	$4,359.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,597.49 / $4,359.89 / $4,359.89	Professional		$3,597.49	$4,359.89	$4,359.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $11,555.07 / $23,022.15 / $41,930.90	Facility		$11,555.07	$23,022.15	$41,930.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7,252.63 / $7,634.35 / $10,306.37	Professional		$7,252.63	$7,634.35	$10,306.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,683.49 / $4,962.33 / $5,733.59	Facility		$4,683.49	$4,962.33	$5,733.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6,107.48 / $6,107.48 / $6,107.48	Professional		$6,107.48	$6,107.48	$6,107.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,938.58 / $4,938.58 / $4,938.58	Facility		$4,938.58	$4,938.58	$4,938.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,938.58 / $4,938.58 / $8,850.37	Professional		$4,938.58	$4,938.58	$8,850.37
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $4,359.89 / $5,516.94 / $5,516.94	Facility		$4,359.89	$5,516.94	$5,516.94
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $4,359.89 / $5,516.94 / $8,586.69	Professional		$4,359.89	$5,516.94	$8,586.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $4,802.00 / $5,649.42 / $6,496.83	Professional		$4,802.00	$5,649.42	$6,496.83
United Facility/Professional Professional Modifier Low / Median / High Price $2,962.80 / $3,649.70 / $5,478.69	Professional		$2,962.80	$3,649.70	$5,478.69