Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $193.15 / $2,877.00 / $5,047.84	Facility		$193.15	$2,877.00	$5,047.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.03 / $190.40 / $295.14	Professional		$133.03	$190.40	$295.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,165.73 / $2,541.92 / $3,443.90	Facility		$2,165.73	$2,541.92	$3,443.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.18 / $213.36 / $374.71	Professional		$38.18	$213.36	$374.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.53 / $211.17 / $389.08	Professional		$142.53	$211.17	$389.08
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $199.99 / $2,877.00 / $5,047.84	Facility		$199.99	$2,877.00	$5,047.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $153.51 / $213.89 / $351.07	Professional		$153.51	$213.89	$351.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $148.13 / $187.35 / $277.49	Professional		$148.13	$187.35	$277.49
United Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $2,704.00 / $4,504.00	Facility		$645.00	$2,704.00	$4,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $195.86 / $237.12 / $326.04	Professional		$195.86	$237.12	$326.04