Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.84 / $122.67 / $645.84	Facility		$91.84	$122.67	$645.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.20 / $51.31 / $104.52	Professional		$34.20	$51.31	$104.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.08 / $115.43 / $204.57	Facility		$83.08	$115.43	$204.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.15 / $93.87 / $160.68	Professional		$49.15	$93.87	$160.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.61 / $75.70 / $126.32	Professional		$52.61	$75.70	$126.32
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $28.86 / $128.80 / $645.84	Facility		$28.86	$128.80	$645.84
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $28.86 / $42.01 / $115.71	Professional		$28.86	$42.01	$115.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $44.54 / $117.88	Professional		$28.59	$44.54	$117.88
United Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $65.95 / $96.67	Professional		$38.36	$65.95	$96.67