Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Facility		$1,288.25	$1,288.25	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,698.24 / $2,454.71	Professional		$1,258.93	$1,698.24	$2,454.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $2,951.21 / $3,467.37	Professional		$1,698.24	$2,951.21	$3,467.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,819.70 / $5,370.32	Facility		$1,288.25	$1,819.70	$5,370.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $3,981.07	Professional		$1,318.26	$1,318.26	$3,981.07
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,737.80 / $1,949.84	Professional		$1,698.24	$1,737.80	$1,949.84
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $2,238.72 / $4,677.35	Facility		$1,288.25	$2,238.72	$4,677.35
Medcost Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $933.25 / $954.99	Professional		$933.25	$933.25	$954.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $1,949.84	Professional		$30.20	$30.20	$1,949.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $2,187.76 / $3,981.07	Facility		$1,778.28	$2,187.76	$3,981.07
United Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,445.44 / $2,187.76	Professional		$1,148.15	$1,445.44	$2,187.76