Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.80 / $2,056.00 / $4,933.00	Facility		$100.80	$2,056.00	$4,933.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $654.72 / $654.72 / $654.72	Facility	50	$654.72	$654.72	$654.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.61 / $117.73 / $176.78	Professional		$76.61	$117.73	$176.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.00 / $190.40 / $447.12	Facility		$141.00	$190.40	$447.12
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $80.64 / $103.09 / $144.97	Facility	50	$80.64	$103.09	$144.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.86 / $115.03 / $138.04	Professional		$21.86	$115.03	$138.04
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $211.44 / $211.44	Professional	50	$123.03	$211.44	$211.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.61 / $126.66 / $233.87	Professional		$71.61	$126.66	$233.87
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $143.44 / $2,056.00 / $4,933.00	Facility		$143.44	$2,056.00	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $654.72 / $654.72 / $654.72	Facility	50	$654.72	$654.72	$654.72
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $104.68 / $143.44 / $208.15	Professional		$104.68	$143.44	$208.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.37 / $135.99 / $193.70	Professional		$109.37	$135.99	$193.70
United Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $3,005.00 / $4,504.00	Facility		$645.00	$3,005.00	$4,504.00
United Facility/Professional Professional Modifier Low / Median / High Price $140.01 / $179.33 / $237.42	Professional		$140.01	$179.33	$237.42