Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.63 / $2,877.00 / $4,933.00	Facility		$137.63	$2,877.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.65 / $146.85 / $201.85	Professional		$104.65	$146.85	$201.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $266.43 / $393.92 / $528.03	Facility		$266.43	$393.92	$528.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.26 / $134.33 / $176.90	Professional		$31.26	$134.33	$176.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.86 / $164.92 / $330.25	Professional		$109.86	$164.92	$330.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $158.50 / $2,877.00 / $4,933.00	Facility		$158.50	$2,877.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $137.62 / $158.50 / $244.82	Professional		$137.62	$158.50	$244.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $108.27 / $134.78 / $194.24	Professional		$108.27	$134.78	$194.24
United Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $1,438.00 / $1,844.00	Facility		$300.00	$1,438.00	$1,844.00
United Facility/Professional Professional Modifier Low / Median / High Price $161.63 / $200.73 / $288.99	Professional		$161.63	$200.73	$288.99