Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.87 / $12.87 / $12.87	Facility		$12.87	$12.87	$12.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.87 / $12.87	Professional		$12.49	$12.87	$12.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,017.45 / $4,643.14 / $9,295.54	Facility		$3,017.45	$4,643.14	$9,295.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $7.73 / $14.14	Professional		$2.00	$7.73	$14.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4.55 / $12.49 / $15.91	Professional		$4.55	$12.49	$15.91
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $12.49 / $12.49 / $18.73	Facility		$12.49	$12.49	$18.73
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.49 / $14.98	Professional		$12.49	$12.49	$14.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $13.78 / $16.91	Professional		$12.49	$13.78	$16.91
United Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $12.49 / $13.65	Professional		$12.49	$12.49	$13.65