Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,755.16 / $4,755.16 / $4,755.16	Facility		$4,755.16	$4,755.16	$4,755.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,892.51 / $4,755.16 / $6,277.70	Professional		$3,892.51	$4,755.16	$6,277.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $16,348.90 / $16,348.90 / $16,348.90	Facility		$16,348.90	$16,348.90	$16,348.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15,531.45 / $16,348.90 / $22,071.02	Professional		$15,531.45	$16,348.90	$22,071.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9,729.49 / $9,729.49 / $9,729.49	Facility		$9,729.49	$9,729.49	$9,729.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $22,188.82 / $22,188.82 / $22,188.82	Professional		$22,188.82	$22,188.82	$22,188.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7,551.49 / $7,551.49 / $7,551.49	Facility		$7,551.49	$7,551.49	$7,551.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7,551.49 / $7,551.49 / $14,096.73	Professional		$7,551.49	$7,551.49	$14,096.73
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $4,755.16 / $15,246.00 / $15,246.00	Facility		$4,755.16	$15,246.00	$15,246.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $4,755.16 / $12,671.21 / $16,867.91	Professional		$4,755.16	$12,671.21	$16,867.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00
United Facility/Professional Professional Modifier Low / Median / High Price $4,632.46 / $7,401.57 / $14,272.59	Professional		$4,632.46	$7,401.57	$14,272.59