Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $825.00 / $4,933.00 / $4,933.00	Facility		$825.00	$4,933.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $825.00 / $825.00 / $935.00	Professional		$825.00	$825.00	$935.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $175.04 / $204.18 / $275.25	Facility		$175.04	$204.18	$275.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $825.00 / $4,933.00 / $4,933.00	Facility		$825.00	$4,933.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $825.00 / $1,300.00 / $1,456.00	Professional		$825.00	$1,300.00	$1,456.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.00	Professional		$30.00	$30.00	$55.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,906.00 / $4,645.00 / $6,327.00	Facility		$1,906.00	$4,645.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,857.00 / $1,857.00 / $1,857.00	Professional		$1,857.00	$1,857.00	$1,857.00