Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $700.00 / $700.00 / $700.00	Facility		$700.00	$700.00	$700.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $700.00 / $700.00 / $700.00	Professional		$700.00	$700.00	$700.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.42 / $157.72 / $304.73	Facility		$81.42	$157.72	$304.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.84 / $55.08 / $65.58	Professional		$49.84	$55.08	$65.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.47 / $96.47 / $96.47	Professional		$96.47	$96.47	$96.47
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $700.00 / $700.00 / $700.00	Facility		$700.00	$700.00	$700.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $87.65 / $700.00 / $700.00	Professional		$87.65	$700.00	$700.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $50.00	Professional		$30.00	$30.00	$50.00