Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.30 / $40.04 / $4,671.03	Facility		$27.30	$40.04	$4,671.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $27.04 / $33.40	Professional		$26.51	$27.04	$33.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.04 / $92.07 / $175.44	Facility		$49.04	$92.07	$175.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $44.73 / $53.76	Professional		$40.86	$44.73	$53.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $26.51 / $42.81	Professional		$26.51	$26.51	$42.81
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $26.51 / $53.92 / $96.13	Facility		$26.51	$53.92	$96.13
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $27.30 / $36.20	Professional		$26.51	$27.30	$36.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $33.09 / $47.71	Professional		$26.51	$33.09	$47.71
United Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $29.51 / $36.15	Professional		$26.51	$29.51	$36.15