Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $328.18 / $4,008.30 / $4,933.00	Facility		$328.18	$4,008.30	$4,933.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,171.52 / $7,063.26 / $7,063.26	Facility	50	$2,171.52	$7,063.26	$7,063.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.93 / $2,679.05 / $4,014.94	Professional		$230.93	$2,679.05	$4,014.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $5,615.42 / $5,615.42 / $5,896.19	Professional	50	$5,615.42	$5,615.42	$5,896.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,521.06 / $6,444.75 / $8,779.52	Facility		$5,521.06	$6,444.75	$8,779.52
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $3,179.61 / $4,580.01 / $5,952.74	Facility	50	$3,179.61	$4,580.01	$5,952.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.67 / $456.55 / $634.78	Professional		$64.67	$456.55	$634.78
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $610.37 / $610.37 / $7,056.69	Professional	50	$610.37	$610.37	$7,056.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $259.11 / $2,146.40 / $5,169.37	Professional		$259.11	$2,146.40	$5,169.37
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $3,696.08 / $4,933.00 / $4,933.00	Facility		$3,696.08	$4,933.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $2,171.52 / $2,171.52 / $7,063.26	Facility	50	$2,171.52	$2,171.52	$7,063.26
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $305.82 / $3,696.08 / $4,804.89	Professional		$305.82	$3,696.08	$4,804.89
Health Alliance Plan Facility/Professional Professional Modifier 50 Low / Median / High Price $5,615.42 / $5,615.42 / $5,896.19	Professional	50	$5,615.42	$5,615.42	$5,896.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,404.03 / $3,005.04 / $4,359.03	Professional		$2,404.03	$3,005.04	$4,359.03
United Facility/Professional Facility Modifier Low / Median / High Price $4,750.00 / $8,514.00 / $15,078.00	Facility		$4,750.00	$8,514.00	$15,078.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,918.06 / $4,648.43 / $8,119.94	Professional		$3,918.06	$4,648.43	$8,119.94