Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $805.20 / $4,933.00 / $4,933.00	Facility		$805.20	$4,933.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $805.20 / $805.20 / $805.20	Professional		$805.20	$805.20	$805.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,573.21 / $6,992.73 / $13,417.71	Facility		$3,573.21	$6,992.73	$13,417.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,284.17 / $3,254.94 / $4,111.50	Professional		$2,284.17	$3,254.94	$4,111.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $805.20 / $4,933.00 / $4,933.00	Facility		$805.20	$4,933.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $805.20 / $805.20 / $2,327.37	Professional		$805.20	$805.20	$2,327.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.00	Professional		$30.00	$30.00	$55.00
United Facility/Professional Facility Modifier Low / Median / High Price $850.00 / $4,645.00 / $6,327.00	Facility		$850.00	$4,645.00	$6,327.00