Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.76 / $218.76 / $273.45	Facility		$218.76	$218.76	$273.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.00 / $273.45 / $273.45	Professional		$216.00	$273.45	$273.45
BCBS Facility/Professional Facility Modifier Low / Median / High Price $156.36 / $223.44 / $397.34	Facility		$156.36	$223.44	$397.34
BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.50 / $150.00 / $202.50	Professional		$142.50	$150.00	$202.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $136.50 / $218.76 / $273.45	Facility		$136.50	$218.76	$273.45
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $136.50 / $136.50 / $273.45	Professional		$136.50	$136.50	$273.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00