Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,794.91 / $5,794.91 / $5,794.91	Facility		$5,794.91	$5,794.91	$5,794.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,829.10 / $5,794.91 / $5,794.91	Professional		$4,829.10	$5,794.91	$5,794.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $15,358.30 / $30,599.66 / $55,732.04	Facility		$15,358.30	$30,599.66	$55,732.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $9,639.76 / $10,147.12 / $13,698.61	Professional		$9,639.76	$10,147.12	$13,698.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6,406.94 / $6,530.84 / $6,595.63	Facility		$6,406.94	$6,530.84	$6,595.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8,117.70 / $8,117.70 / $8,117.70	Professional		$8,117.70	$8,117.70	$8,117.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,957.05 / $7,957.05 / $7,957.05	Facility		$7,957.05	$7,957.05	$7,957.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $6,763.49 / $7,957.05 / $11,763.75	Professional		$6,763.49	$7,957.05	$11,763.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $5,794.91 / $7,332.78 / $7,332.78	Facility		$5,794.91	$7,332.78	$7,332.78
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $5,794.91 / $7,332.78 / $11,412.93	Professional		$5,794.91	$7,332.78	$11,412.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $3,258.12 / $3,258.12	Professional		$75.00	$3,258.12	$3,258.12
United Facility/Professional Facility Modifier Low / Median / High Price $10,147.53 / $11,938.27 / $11,938.27	Facility		$10,147.53	$11,938.27	$11,938.27
United Facility/Professional Professional Modifier Low / Median / High Price $3,722.42 / $4,850.97 / $7,084.48	Professional		$3,722.42	$4,850.97	$7,084.48