Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.25 / $2,056.00 / $4,933.00	Facility		$139.25	$2,056.00	$4,933.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,023.68 / $2,023.68 / $2,023.68	Facility	50	$2,023.68	$2,023.68	$2,023.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.60 / $144.61 / $231.16	Professional		$97.60	$144.61	$231.16
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $260.91 / $260.91 / $260.91	Professional	50	$260.91	$260.91	$260.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.30 / $192.46 / $259.45	Facility		$164.30	$192.46	$259.45
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $110.05 / $120.13 / $175.91	Facility	50	$110.05	$120.13	$175.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.44 / $167.32 / $279.17	Professional		$28.44	$167.32	$279.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.19 / $159.56 / $281.73	Professional		$81.19	$159.56	$281.73
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $180.25 / $2,056.00 / $4,933.00	Facility		$180.25	$2,056.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $2,023.68 / $2,023.68 / $2,023.68	Facility	50	$2,023.68	$2,023.68	$2,023.68
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $121.26 / $180.25 / $284.97	Professional		$121.26	$180.25	$284.97
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $260.91 / $260.91 / $260.91	Professional	50	$260.91	$260.91	$260.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $117.74 / $154.24 / $228.52	Professional		$117.74	$154.24	$228.52
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,029.00	Facility		$464.00	$1,428.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $172.55 / $223.90 / $310.57	Professional		$172.55	$223.90	$310.57