Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.83 / $123.83 / $193.18	Facility		$123.83	$123.83	$193.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.10 / $123.83 / $123.83	Professional		$112.10	$123.83	$123.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.74 / $147.44 / $258.95	Facility		$105.74	$147.44	$258.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.87 / $97.76 / $104.60	Professional		$92.87	$97.76	$104.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.20 / $106.79 / $198.76	Professional		$66.20	$106.79	$198.76
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $117.64 / $123.83 / $227.54	Facility		$117.64	$123.83	$227.54
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $117.30 / $173.54 / $195.53	Professional		$117.30	$173.54	$195.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.93 / $118.72 / $145.70	Professional		$107.93	$118.72	$145.70
United Facility/Professional Professional Modifier Low / Median / High Price $54.75 / $106.69 / $169.46	Professional		$54.75	$106.69	$169.46