Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.99 / $28.99 / $28.99	Facility		$28.99	$28.99	$28.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.17 / $28.99 / $30.44	Professional		$17.17	$28.99	$30.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.24 / $114.80 / $218.21	Facility		$55.24	$114.80	$218.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $39.59 / $49.49	Professional		$36.17	$39.59	$49.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.44 / $19.44 / $55.31	Professional		$19.44	$19.44	$55.31
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $27.51 / $27.51 / $31.63	Facility		$27.51	$27.51	$31.63
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $26.33 / $27.51 / $45.68	Professional		$26.33	$27.51	$45.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $27.45 / $42.96	Professional		$23.87	$27.45	$42.96
United Facility/Professional Professional Modifier Low / Median / High Price $13.46 / $18.20 / $27.25	Professional		$13.46	$18.20	$27.25