Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,516.60 / $1,516.60 / $1,516.60	Facility		$1,516.60	$1,516.60	$1,516.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,263.83 / $1,516.60 / $1,516.60	Professional		$1,263.83	$1,516.60	$1,516.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,655.63 / $2,655.63 / $2,655.63	Facility		$2,655.63	$2,655.63	$2,655.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,522.85 / $2,655.63 / $3,585.10	Professional		$2,522.85	$2,655.63	$3,585.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,662.65 / $1,726.16 / $1,763.93	Facility		$1,662.65	$1,726.16	$1,763.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,124.50 / $2,124.50 / $2,124.50	Professional		$2,124.50	$2,124.50	$2,124.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,482.94 / $1,482.94 / $1,482.94	Facility		$1,482.94	$1,482.94	$1,482.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,482.94 / $1,482.94 / $3,078.75	Professional		$1,482.94	$1,482.94	$3,078.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,516.60 / $1,919.07 / $1,919.07	Facility		$1,516.60	$1,919.07	$1,919.07
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,516.60 / $1,919.07 / $2,986.90	Professional		$1,516.60	$1,919.07	$2,986.90
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 $986.66 / $1,269.55 / $1,900.68	Professional		$986.66	$1,269.55	$1,900.68