Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $775.86 / $4,933.00 / $4,933.00	Facility		$775.86	$4,933.00	$4,933.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $155.16 / $155.16 / $155.16	Facility	53	$155.16	$155.16	$155.16
BCBS Facility/Professional Facility Modifier Low / Median / High Price $344.21 / $685.81 / $1,249.08	Facility		$344.21	$685.81	$1,249.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $616.23 / $831.91 / $915.26	Facility		$616.23	$831.91	$915.26
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $720.24 / $925.26 / $4,933.00	Facility		$720.24	$925.26	$4,933.00
Health Alliance Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $155.16 / $155.16 / $155.16	Facility	53	$155.16	$155.16	$155.16
United Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $11,152.00 / $25,000.00	Facility		$5,000.00	$11,152.00	$25,000.00