Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.09 / $4,933.00 / $4,933.00	Facility		$106.09	$4,933.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.23 / $93.99 / $106.09	Professional		$75.23	$93.99	$106.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $379.16 / $450.20 / $618.34	Facility		$379.16	$450.20	$618.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.86 / $80.40 / $137.19	Professional		$21.86	$80.40	$137.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.26 / $112.05 / $209.02	Professional		$80.26	$112.05	$209.02
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $85.45 / $4,933.00 / $4,933.00	Facility		$85.45	$4,933.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $82.84 / $90.73 / $130.13	Professional		$82.84	$90.73	$130.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $82.26 / $102.24 / $147.23	Professional		$82.26	$102.24	$147.23
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 $86.98 / $112.05 / $164.43	Professional		$86.98	$112.05	$164.43