Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.81 / $170.81 / $520.45	Facility		$166.81	$170.81	$520.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $170.81 / $195.97	Professional		$165.83	$170.81	$195.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.99 / $369.27 / $698.56	Facility		$204.99	$369.27	$698.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.50 / $168.95 / $168.95	Professional		$160.50	$168.95	$168.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.95 / $165.83 / $165.83	Professional		$106.95	$165.83	$165.83
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $165.83 / $208.51 / $464.15	Facility		$165.83	$208.51	$464.15
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $166.81 / $198.99	Professional		$165.83	$166.81	$198.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $186.25 / $187.87 / $190.70	Professional		$186.25	$187.87	$190.70
United Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $169.16	Professional		$165.83	$165.83	$169.16