Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.79 / $97.79 / $97.79	Facility		$97.79	$97.79	$97.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.84 / $97.79 / $97.79	Professional		$73.84	$97.79	$97.79
BCBS Facility/Professional Facility Modifier Low / Median / High Price $429.39 / $500.47 / $678.06	Facility		$429.39	$500.47	$678.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.70 / $76.08 / $130.16	Professional		$20.70	$76.08	$130.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.13 / $99.65 / $163.51	Professional		$62.13	$99.65	$163.51
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $80.70 / $80.70 / $97.79	Facility		$80.70	$80.70	$97.79
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $80.70 / $84.86 / $130.91	Professional		$80.70	$84.86	$130.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $55.00 / $169.93	Professional		$30.00	$55.00	$169.93
United Facility/Professional Facility Modifier Low / Median / High Price $464.00 / $1,428.00 / $2,029.00	Facility		$464.00	$1,428.00	$2,029.00
United Facility/Professional Professional Modifier Low / Median / High Price $89.28 / $102.02 / $137.91	Professional		$89.28	$102.02	$137.91