Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $201.50 / $2,237.04 / $4,933.00	Facility		$201.50	$2,237.04	$4,933.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,171.52 / $2,552.61 / $13,706.97	Facility	50	$2,171.52	$2,552.61	$13,706.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.83 / $1,424.13 / $2,130.52	Professional		$158.83	$1,424.13	$2,130.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,552.85 / $2,885.34 / $2,885.34	Professional	50	$1,552.85	$2,885.34	$2,885.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,583.84 / $6,508.16 / $8,817.52	Facility		$5,583.84	$6,508.16	$8,817.52
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $3,504.60 / $4,082.65 / $5,978.51	Facility	50	$3,504.60	$4,082.65	$5,978.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.13 / $224.24 / $407.18	Professional		$40.13	$224.24	$407.18
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $378.68 / $378.68 / $3,758.82	Professional	50	$378.68	$378.68	$3,758.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.19 / $1,140.83 / $2,890.05	Professional		$160.19	$1,140.83	$2,890.05
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $213.01 / $4,112.00 / $5,756.00	Facility		$213.01	$4,112.00	$5,756.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $2,171.52 / $2,552.61 / $13,706.97	Facility	50	$2,171.52	$2,552.61	$13,706.97
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $193.75 / $2,070.46 / $2,708.12	Professional		$193.75	$2,070.46	$2,708.12
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $1,552.85 / $2,885.34 / $2,885.34	Professional	50	$1,552.85	$2,885.34	$2,885.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,275.55 / $1,594.44 / $2,295.99	Professional		$1,275.55	$1,594.44	$2,295.99
United Facility/Professional Facility Modifier Low / Median / High Price $3,296.00 / $7,849.00 / $9,202.00	Facility		$3,296.00	$7,849.00	$9,202.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,050.92 / $2,461.11 / $3,355.59	Professional		$2,050.92	$2,461.11	$3,355.59