Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $186.21	Professional		$112.20	$147.91	$186.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $275.42 / $323.59	Professional		$204.17	$275.42	$323.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $165.96 / $213.80	Facility		$147.91	$165.96	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $165.96 / $295.12	Professional		$141.25	$165.96	$295.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Medcost Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $186.21 / $398.11	Facility		$123.03	$186.21	$398.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $102.33	Professional		$87.10	$87.10	$102.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $125.89 / $165.96	Professional		$16.60	$125.89	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $114.82 / $181.97	Facility		$14.79	$114.82	$181.97
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $223.87	Professional		$102.33	$138.04	$223.87