Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,022.69 / $2,247.44 / $2,247.44	Facility		$2,022.69	$2,247.44	$2,247.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,623.04 / $2,022.69 / $2,247.44	Professional		$1,623.04	$2,022.69	$2,247.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,956.40 / $11,867.44 / $21,614.52	Facility		$5,956.40	$11,867.44	$21,614.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,738.58 / $3,935.35 / $5,312.72	Professional		$3,738.58	$3,935.35	$5,312.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $802.19 / $2,005.45 / $2,557.98	Facility		$802.19	$2,005.45	$2,557.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,259.31 / $2,990.86 / $3,148.28	Professional		$1,259.31	$2,990.86	$3,148.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,253.75 / $2,253.75 / $2,253.75	Facility		$2,253.75	$2,253.75	$2,253.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,253.75 / $2,253.75 / $4,562.25	Professional		$2,253.75	$2,253.75	$4,562.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,247.44 / $2,843.87 / $2,843.87	Facility		$2,247.44	$2,843.87	$2,843.87
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $2,022.69 / $2,843.87 / $4,426.27	Professional		$2,022.69	$2,843.87	$4,426.27
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 $1,227.07 / $1,881.35 / $2,816.61	Professional		$1,227.07	$1,881.35	$2,816.61