Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,056.00 / $2,056.00 / $4,933.00	Facility		$2,056.00	$2,056.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $126.00 / $126.00	Professional		$126.00	$126.00	$126.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.29 / $146.29 / $146.29	Facility		$146.29	$146.29	$146.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.97 / $153.60 / $182.86	Professional		$138.97	$153.60	$182.86
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $2,056.00 / $2,878.00 / $4,933.00	Facility		$2,056.00	$2,878.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $369.77 / $4,933.00	Professional		$126.00	$369.77	$4,933.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.00	Professional		$30.00	$30.00	$55.00
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,438.00 / $1,844.00	Facility		$300.00	$1,438.00	$1,844.00