Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.94 / $2,056.00 / $4,933.00	Facility		$128.94	$2,056.00	$4,933.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $64.47 / $64.47 / $246.92	Facility	52	$64.47	$64.47	$246.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.39 / $351.41 / $493.84	Professional		$100.39	$351.41	$493.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $400.64 / $589.64 / $1,350.07	Facility		$400.64	$589.64	$1,350.07
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.43 / $78.78 / $134.82	Professional		$21.43	$78.78	$134.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.30 / $297.32 / $796.96	Professional		$117.30	$297.32	$796.96
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $459.24 / $2,056.00 / $4,933.00	Facility		$459.24	$2,056.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 52 Low / Median / High Price $64.47 / $64.47 / $246.92	Facility	52	$64.47	$64.47	$246.92
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $128.94 / $459.24 / $602.20	Professional		$128.94	$459.24	$602.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $326.25 / $407.81 / $583.98	Professional		$326.25	$407.81	$583.98
United Facility/Professional Facility Modifier Low / Median / High Price $773.00 / $3,005.00 / $4,504.00	Facility		$773.00	$3,005.00	$4,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $504.75 / $576.85 / $769.14	Professional		$504.75	$576.85	$769.14