Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.68 / $326.69 / $4,933.00	Facility		$139.68	$326.69	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.28 / $158.57 / $283.37	Professional		$98.28	$158.57	$283.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $260.92 / $309.81 / $425.52	Facility		$260.92	$309.81	$425.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.44 / $116.31 / $185.73	Professional		$28.44	$116.31	$185.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.49 / $201.39 / $394.95	Professional		$113.49	$201.39	$394.95
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $146.66 / $326.69 / $4,933.00	Facility		$146.66	$326.69	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $139.68 / $188.07 / $311.13	Professional		$139.68	$188.07	$311.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $135.76 / $168.40 / $242.50	Professional		$135.76	$168.40	$242.50
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 $182.85 / $239.05 / $319.33	Professional		$182.85	$239.05	$319.33