Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $345.89 / $2,056.00 / $4,933.00	Facility		$345.89	$2,056.00	$4,933.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $259.42 / $269.39 / $293.47	Facility	54	$259.42	$269.39	$293.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.46 / $294.37 / $521.71	Professional		$220.46	$294.37	$521.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $216.58 / $255.48 / $344.40	Facility		$216.58	$255.48	$344.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.95 / $421.02 / $698.42	Professional		$71.95	$421.02	$698.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.76 / $312.30 / $577.82	Professional		$221.76	$312.30	$577.82
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $288.82 / $2,056.00 / $4,933.00	Facility		$288.82	$2,056.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 54 Low / Median / High Price $259.42 / $259.42 / $282.60	Facility	54	$259.42	$259.42	$282.60
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $260.32 / $340.93 / $528.08	Professional		$260.32	$340.93	$528.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.81 / $195.22 / $360.97	Professional		$33.81	$195.22	$360.97
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,418.00 / $2,029.00	Facility		$300.00	$1,418.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $281.72 / $339.29 / $464.62	Professional		$281.72	$339.29	$464.62