Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.26 / $162.26 / $162.26	Facility		$162.26	$162.26	$162.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.26 / $162.26 / $162.26	Professional		$162.26	$162.26	$162.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $196.38 / $294.52 / $625.63	Facility		$196.38	$294.52	$625.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.57 / $169.02 / $228.18	Professional		$160.57	$169.02	$228.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $172.40 / $172.40	Professional		$139.72	$172.40	$172.40
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $162.26 / $179.16 / $202.90	Facility		$162.26	$179.16	$202.90
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $162.26 / $179.16 / $214.99	Professional		$162.26	$179.16	$214.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $202.82 / $202.82 / $223.10	Professional		$202.82	$202.82	$223.10