Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Facility		$5.00	$5.00	$5.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $5.00 / $5.00	Professional		$3.00	$5.00	$5.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $555.01 / $1,153.47 / $2,192.38	Facility		$555.01	$1,153.47	$2,192.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.38 / $397.80 / $516.38	Professional		$363.38	$397.80	$516.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.24 / $31.24 / $31.24	Professional		$31.24	$31.24	$31.24
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Facility		$5.00	$5.00	$5.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Professional		$5.00	$5.00	$5.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.00	Professional		$30.00	$30.00	$55.00