Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $178.88 / $272.24 / $4,933.00	Facility		$178.88	$272.24	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.96 / $197.38 / $272.24	Professional		$130.96	$197.38	$272.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $238.30 / $277.75 / $376.30	Facility		$238.30	$277.75	$376.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.36 / $119.32 / $227.27	Professional		$36.36	$119.32	$227.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.43 / $212.17 / $648.87	Professional		$133.43	$212.17	$648.87
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $225.38 / $272.24 / $4,933.00	Facility		$225.38	$272.24	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $178.88 / $232.09 / $302.95	Professional		$178.88	$232.09	$302.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $163.59 / $202.65 / $282.48	Professional		$163.59	$202.65	$282.48
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,418.00 / $2,449.00	Facility		$464.00	$1,418.00	$2,449.00
United Facility/Professional Professional Modifier Low / Median / High Price $216.32 / $255.32 / $332.87	Professional		$216.32	$255.32	$332.87