Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,715.22 / $3,715.22 / $3,715.22	Facility		$3,715.22	$3,715.22	$3,715.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,044.55 / $3,715.22 / $3,715.22	Professional		$3,044.55	$3,715.22	$3,715.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,846.48 / $19,617.99 / $35,730.81	Facility		$9,846.48	$19,617.99	$35,730.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $6,180.22 / $6,505.50 / $8,782.43	Professional		$6,180.22	$6,505.50	$8,782.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,035.76 / $4,140.05 / $4,228.58	Facility		$4,035.76	$4,140.05	$4,228.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5,204.39 / $5,204.39 / $5,204.39	Professional		$5,204.39	$5,204.39	$5,204.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,799.01 / $3,799.01 / $3,799.01	Facility		$3,799.01	$3,799.01	$3,799.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,799.01 / $3,799.01 / $7,542.00	Professional		$3,799.01	$3,799.01	$7,542.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $3,715.22 / $4,701.18 / $4,701.18	Facility		$3,715.22	$4,701.18	$4,701.18
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $3,715.22 / $4,701.18 / $7,265.00	Professional		$3,715.22	$4,701.18	$7,265.00
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 $2,380.01 / $3,110.05 / $4,656.10	Professional		$2,380.01	$3,110.05	$4,656.10