Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.43 / $4,933.00 / $4,933.00	Facility		$138.43	$4,933.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.98 / $121.20 / $138.43	Professional		$95.98	$121.20	$138.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $392.90 / $580.91 / $778.69	Facility		$392.90	$580.91	$778.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $123.73 / $190.03	Professional		$28.00	$123.73	$190.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.94 / $133.66 / $261.58	Professional		$103.94	$133.66	$261.58
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $113.33 / $4,933.00 / $4,933.00	Facility		$113.33	$4,933.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $107.07 / $119.78 / $171.62	Professional		$107.07	$119.78	$171.62
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 $111.13 / $141.62 / $181.31	Professional		$111.13	$141.62	$181.31