Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,187.29 / $1,187.29 / $1,187.29	Facility		$1,187.29	$1,187.29	$1,187.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $995.00 / $1,187.29 / $1,527.08	Professional		$995.00	$1,187.29	$1,527.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,448.83 / $10,856.16 / $19,772.64	Facility		$5,448.83	$10,856.16	$19,772.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,420.00 / $3,600.00 / $4,860.00	Professional		$3,420.00	$3,600.00	$4,860.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,318.95 / $1,351.35 / $1,358.68	Facility		$1,318.95	$1,351.35	$1,358.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,663.20 / $1,663.20 / $1,663.20	Professional		$1,663.20	$1,663.20	$1,663.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,650.90 / $1,650.90 / $1,650.90	Facility		$1,650.90	$1,650.90	$1,650.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,650.90 / $1,650.90 / $3,850.00	Professional		$1,650.90	$1,650.90	$3,850.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,187.29 / $2,326.27 / $2,326.27	Facility		$1,187.29	$2,326.27	$2,326.27
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,187.29 / $2,120.58 / $2,598.75	Professional		$1,187.29	$2,120.58	$2,598.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $75.00	Professional		$30.00	$30.00	$75.00
United Facility/Professional Facility Modifier Low / Median / High Price $15.31 / $1,235.70 / $2,162.13	Facility		$15.31	$1,235.70	$2,162.13
United Facility/Professional Professional Modifier Low / Median / High Price $772.32 / $1,511.70 / $2,211.31	Professional		$772.32	$1,511.70	$2,211.31