Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.84 / $4,933.00 / $4,933.00	Facility		$147.84	$4,933.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.86 / $132.01 / $147.84	Professional		$107.86	$132.01	$147.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $428.39 / $633.38 / $874.44	Facility		$428.39	$633.38	$874.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.53 / $120.62 / $189.64	Professional		$28.53	$120.62	$189.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.76 / $167.09 / $307.16	Professional		$110.76	$167.09	$307.16
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $139.91 / $4,933.00 / $4,933.00	Facility		$139.91	$4,933.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $115.16 / $139.91 / $183.74	Professional		$115.16	$139.91	$183.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.55 / $138.75 / $201.33	Professional		$107.55	$138.75	$201.33
United Facility/Professional Facility Modifier Low / Median / High Price $850.00 / $4,645.00 / $6,036.00	Facility		$850.00	$4,645.00	$6,036.00
United Facility/Professional Professional Modifier Low / Median / High Price $121.62 / $171.13 / $248.57	Professional		$121.62	$171.13	$248.57