Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,491.92 / $4,491.92 / $4,491.92	Facility		$4,491.92	$4,491.92	$4,491.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,743.27 / $4,491.92 / $4,491.92	Professional		$3,743.27	$4,491.92	$4,491.92
BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,865.54 / $7,865.54 / $7,865.54	Facility		$7,865.54	$7,865.54	$7,865.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $7,472.26 / $7,865.54 / $10,618.48	Professional		$7,472.26	$7,865.54	$10,618.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,990.05 / $5,112.60 / $5,140.30	Facility		$4,990.05	$5,112.60	$5,140.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6,292.43 / $6,292.43 / $6,292.43	Professional		$6,292.43	$6,292.43	$6,292.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,391.66 / $4,391.66 / $4,391.66	Facility		$4,391.66	$4,391.66	$4,391.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,391.66 / $4,391.66 / $9,118.50	Professional		$4,391.66	$4,391.66	$9,118.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $4,491.92 / $5,684.00 / $5,684.00	Facility		$4,491.92	$5,684.00	$5,684.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $4,491.92 / $5,684.00 / $8,846.73	Professional		$4,491.92	$5,684.00	$8,846.73
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 $2,921.93 / $3,760.22 / $5,629.52	Professional		$2,921.93	$3,760.22	$5,629.52