Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.22 / $112.22 / $112.22	Facility		$112.22	$112.22	$112.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.90 / $112.22 / $126.24	Professional		$79.90	$112.22	$126.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $213.83 / $444.41 / $844.68	Facility		$213.83	$444.41	$844.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $153.26 / $198.95	Professional		$140.00	$153.26	$198.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.12 / $60.12 / $217.17	Professional		$60.12	$60.12	$217.17
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $100.41 / $100.41 / $112.22	Facility		$100.41	$100.41	$112.22
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $100.41 / $100.41 / $176.84	Professional		$100.41	$100.41	$176.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $86.53 / $95.18 / $155.75	Professional		$86.53	$95.18	$155.75
United Facility/Professional Professional Modifier Low / Median / High Price $50.13 / $69.20 / $106.39	Professional		$50.13	$69.20	$106.39