Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.20 / $73.20 / $349.68	Facility		$73.20	$73.20	$349.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $82.37 / $88.36	Professional		$73.20	$82.37	$88.36
BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.79 / $169.48 / $312.36	Facility		$97.79	$169.48	$312.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $112.50 / $162.91	Professional		$69.73	$112.50	$162.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.78 / $69.73 / $69.73	Facility		$65.78	$69.73	$69.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $95.63	Professional		$69.73	$69.73	$95.63
Medcost Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $73.20 / $183.11	Facility		$69.73	$73.20	$183.11
Medcost Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $84.00 / $84.00	Professional		$73.20	$84.00	$84.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $70.09 / $111.30	Professional		$59.33	$70.09	$111.30
United Facility/Professional Professional Modifier Low / Median / High Price $27.89 / $69.73 / $69.73	Professional		$27.89	$69.73	$69.73