Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $211.10 / $211.10 / $1,889.58	Facility		$211.10	$211.10	$1,889.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $211.10 / $211.10	Professional		$204.96	$211.10	$211.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,130.63 / $1,746.38 / $3,480.96	Facility		$1,130.63	$1,746.38	$3,480.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $187.94 / $205.74 / $257.18	Professional		$187.94	$205.74	$257.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $668.80	Professional		$204.96	$204.96	$668.80
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $214.89 / $1,266.67	Facility		$204.96	$214.89	$1,266.67
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $276.69	Professional		$204.96	$204.96	$276.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $262.93 / $368.92	Professional		$204.96	$262.93	$368.92
United Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $220.91	Professional		$204.96	$204.96	$220.91