Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,102.00 / $1,102.00 / $1,719.12	Facility		$1,102.00	$1,102.00	$1,719.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $991.80 / $1,102.00 / $1,102.00	Professional		$991.80	$1,102.00	$1,102.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,295.69 / $1,806.73 / $3,173.22	Facility		$1,295.69	$1,806.73	$3,173.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,138.04 / $1,197.94 / $1,281.80	Professional		$1,138.04	$1,197.94	$1,281.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $530.38 / $587.91 / $1,767.13	Professional		$530.38	$587.91	$1,767.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,102.00 / $1,102.00 / $2,024.92	Facility		$1,102.00	$1,102.00	$2,024.92
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,102.00 / $1,113.59 / $1,437.52	Professional		$1,102.00	$1,113.59	$1,437.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $487.20 / $696.00 / $1,160.00	Professional		$487.20	$696.00	$1,160.00