Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.45 / $150.99 / $4,933.00	Facility		$67.45	$150.99	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.45 / $117.47 / $158.80	Professional		$82.45	$117.47	$158.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.78 / $125.63 / $170.20	Facility		$107.78	$125.63	$170.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.30 / $131.55 / $199.22	Professional		$25.30	$131.55	$199.22
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $202.92 / $202.92 / $287.61	Professional	50	$202.92	$202.92	$287.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.97 / $125.41 / $192.30	Professional		$79.97	$125.41	$192.30
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $67.45 / $150.99 / $4,933.00	Facility		$67.45	$150.99	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $106.85 / $119.63 / $203.37	Professional		$106.85	$119.63	$203.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $102.47 / $146.41	Professional		$81.79	$102.47	$146.41
United Facility/Professional Facility Modifier Low / Median / High Price $773.00 / $3,005.00 / $4,504.00	Facility		$773.00	$3,005.00	$4,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $131.93 / $156.65 / $201.86	Professional		$131.93	$156.65	$201.86