Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.67 / $57.67 / $57.67	Facility		$57.67	$57.67	$57.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.67 / $57.67 / $57.67	Professional		$57.67	$57.67	$57.67
BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.85 / $195.16 / $267.25	Facility		$134.85	$195.16	$267.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.50 / $18.98 / $24.08	Professional		$4.50	$18.98	$24.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.73 / $22.90 / $181.16	Professional		$10.73	$22.90	$181.16
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $57.67 / $134.19 / $154.31	Facility		$57.67	$134.19	$154.31
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $57.67 / $134.19 / $171.37	Professional		$57.67	$134.19	$171.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.00	Professional		$30.00	$30.00	$55.00
United Facility/Professional Professional Modifier Low / Median / High Price $47.19 / $83.89 / $139.81	Professional		$47.19	$83.89	$139.81