Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $791.70 / $4,933.00 / $4,933.00	Facility		$791.70	$4,933.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $791.70 / $791.70 / $791.70	Professional		$791.70	$791.70	$791.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $174.31 / $203.16 / $275.25	Facility		$174.31	$203.16	$275.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.79 / $631.26 / $898.76	Professional		$152.79	$631.26	$898.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,143.44 / $1,143.44 / $1,177.74	Professional		$1,143.44	$1,143.44	$1,177.74
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $791.70 / $4,933.00 / $4,933.00	Facility		$791.70	$4,933.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $714.58 / $791.70 / $1,827.70	Professional		$714.58	$791.70	$1,827.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.00	Professional		$30.00	$30.00	$55.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,906.00 / $4,645.00 / $6,327.00	Facility		$1,906.00	$4,645.00	$6,327.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,098.46 / $1,285.23 / $1,597.76	Professional		$1,098.46	$1,285.23	$1,597.76