Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.24 / $163.24 / $163.24	Facility		$163.24	$163.24	$163.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.24 / $163.24 / $179.56	Professional		$163.24	$163.24	$179.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.33 / $350.08 / $662.25	Facility		$194.33	$350.08	$662.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $152.16 / $152.16 / $160.16	Professional		$152.16	$152.16	$160.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.71 / $179.39 / $182.45	Professional		$101.71	$179.39	$182.45
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $163.24 / $192.05 / $192.05	Facility		$163.24	$192.05	$192.05
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $163.24 / $192.05 / $230.46	Professional		$163.24	$192.05	$230.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $164.98 / $192.05 / $204.58	Professional		$164.98	$192.05	$204.58