Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,875.00 / $4,933.00 / $4,933.00	Facility		$1,875.00	$4,933.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,875.00 / $1,875.00 / $2,125.00	Professional		$1,875.00	$1,875.00	$2,125.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $175.04 / $204.18 / $287.27	Facility		$175.04	$204.18	$287.27
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,875.00 / $4,933.00 / $4,933.00	Facility		$1,875.00	$4,933.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,875.00 / $1,875.00 / $2,714.25	Professional		$1,875.00	$1,875.00	$2,714.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $75.00	Professional		$30.00	$30.00	$75.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,906.00 / $4,645.00 / $6,740.00	Facility		$1,906.00	$4,645.00	$6,740.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,747.92 / $2,747.92 / $2,747.92	Professional		$2,747.92	$2,747.92	$2,747.92