Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,933.00 / $4,933.00 / $4,933.00	Facility		$4,933.00	$4,933.00	$4,933.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,900.00 / $4,549.22 / $6,132.72	Facility		$3,900.00	$4,549.22	$6,132.72
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $4,933.00 / $4,933.00 / $4,933.00	Facility		$4,933.00	$4,933.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $4,933.00 / $4,933.00 / $4,933.00	Professional		$4,933.00	$4,933.00	$4,933.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00
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