Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.61 / $2,056.00 / $4,933.00	Facility		$149.61	$2,056.00	$4,933.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $492.61 / $492.61 / $492.61	Facility	50	$492.61	$492.61	$492.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.25 / $193.09 / $345.84	Professional		$137.25	$193.09	$345.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.96 / $174.54 / $245.56	Facility		$147.96	$174.54	$245.56
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $85.21 / $108.94 / $159.53	Facility	50	$85.21	$108.94	$159.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.09 / $125.32 / $300.77	Professional		$34.09	$125.32	$300.77
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $289.20 / $289.20 / $595.19	Professional	50	$289.20	$289.20	$595.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.00 / $186.14 / $404.48	Professional		$107.00	$186.14	$404.48
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $158.15 / $322.33 / $4,933.00	Facility		$158.15	$322.33	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 50 Low / Median / High Price $492.61 / $492.61 / $492.61	Facility	50	$492.61	$492.61	$492.61
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $149.61 / $217.43 / $365.90	Professional		$149.61	$217.43	$365.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.69 / $192.46 / $289.27	Professional		$30.69	$192.46	$289.27
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 $155.65 / $264.43 / $347.79	Professional		$155.65	$264.43	$347.79