Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.00 / $8.00 / $8.00	Facility		$8.00	$8.00	$8.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.00 / $8.00 / $8.00	Professional		$8.00	$8.00	$8.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $120.68 / $247.16	Facility		$45.00	$120.68	$247.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $47.25 / $56.25	Professional		$42.75	$47.25	$56.25
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $8.00 / $8.00 / $8.00	Facility		$8.00	$8.00	$8.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $8.00 / $8.00 / $8.00	Professional		$8.00	$8.00	$8.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $100.00	Professional		$30.00	$30.00	$100.00