Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.40 / $86.70 / $86.70	Facility		$71.40	$86.70	$86.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.62 / $86.70 / $86.70	Professional		$67.62	$86.70	$86.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $137.68 / $189.61 / $337.18	Facility		$137.68	$189.61	$337.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.81 / $132.38 / $150.72	Professional		$20.81	$132.38	$150.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.62 / $123.63 / $200.69	Professional		$80.62	$123.63	$200.69
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $71.40 / $78.08 / $86.70	Facility		$71.40	$78.08	$86.70
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $78.08 / $86.70 / $129.21	Professional		$78.08	$86.70	$129.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.89 / $64.69 / $85.48	Professional		$53.89	$64.69	$85.48
United Facility/Professional Professional Modifier Low / Median / High Price $80.16 / $103.61 / $150.79	Professional		$80.16	$103.61	$150.79