Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.00 / $114.00 / $177.84	Facility		$114.00	$114.00	$177.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.20 / $114.00 / $114.00	Professional		$103.20	$114.00	$114.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.34 / $135.74 / $238.40	Facility		$97.34	$135.74	$238.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.50 / $90.00 / $96.30	Professional		$85.50	$90.00	$96.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.98 / $120.00 / $270.00	Professional		$54.98	$120.00	$270.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $112.90 / $114.00 / $209.48	Facility		$112.90	$114.00	$209.48
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $103.20 / $112.90 / $144.00	Professional		$103.20	$112.90	$144.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $75.00	Professional		$30.00	$30.00	$75.00
United Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $72.00 / $156.00	Professional		$50.40	$72.00	$156.00