Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.37 / $67.37 / $67.37	Facility		$67.37	$67.37	$67.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $67.37 / $67.37	Professional		$65.41	$67.37	$67.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,552.59 / $2,389.07 / $4,782.89	Facility		$1,552.59	$2,389.07	$4,782.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $5.51 / $16.07 / $34.28	Professional		$5.51	$16.07	$34.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $65.40 / $83.30	Professional		$38.29	$65.40	$83.30
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $65.41 / $65.41 / $98.12	Facility		$65.41	$65.41	$98.12
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $65.41 / $79.95	Professional		$65.41	$65.41	$79.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $75.00 / $100.00	Professional		$65.41	$75.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $65.41 / $65.41 / $70.50	Professional		$65.41	$65.41	$70.50