Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.28 / $113.28 / $353.43	Facility		$113.28	$113.28	$353.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.28 / $113.28 / $113.28	Professional		$113.28	$113.28	$113.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.72 / $260.73 / $493.23	Facility		$144.72	$260.73	$493.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.33 / $119.29 / $119.29	Professional		$113.33	$119.29	$119.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.58 / $120.36 / $120.36	Professional		$118.58	$120.36	$120.36
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $113.28 / $141.60 / $315.20	Facility		$113.28	$141.60	$315.20
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $113.28 / $125.08 / $150.09	Professional		$113.28	$125.08	$150.09
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 $118.00 / $118.00 / $125.19	Professional		$118.00	$118.00	$125.19