Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $50.00	Facility		$50.00	$50.00	$50.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $48.00 / $330.00	Professional		$35.00	$48.00	$330.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,260.00 / $1,260.00 / $1,260.00	Professional	AA	$1,260.00	$1,260.00	$1,260.00
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $140.77 / $140.77 / $140.77	Professional	QZ	$140.77	$140.77	$140.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $56,799.99 / $68,899.99 / $81,099.99	Facility		$56,799.99	$68,899.99	$81,099.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.58 / $228.00 / $240.00	Professional		$110.58	$228.00	$240.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $315.00 / $390.00	Professional		$275.00	$315.00	$390.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $92.15 / $350.00 / $1,500.00	Professional		$92.15	$350.00	$1,500.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $390.00 / $499.50	Professional		$275.00	$390.00	$499.50
Providence Facility/Professional Professional Modifier QX Low / Median / High Price $174.00 / $233.10 / $243.00	Professional	QX	$174.00	$233.10	$243.00
Providence Facility/Professional Professional Modifier QY Low / Median / High Price $174.00 / $233.10 / $243.00	Professional	QY	$174.00	$233.10	$243.00
United Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $60.00 / $90.00	Professional		$43.00	$60.00	$90.00