Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.90 / $109.90 / $109.90	Facility		$109.90	$109.90	$109.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $107.76 / $109.90	Professional		$106.70	$107.76	$109.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $314.99 / $484.70 / $970.36	Facility		$314.99	$484.70	$970.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.40 / $70.58 / $95.28	Professional		$11.40	$70.58	$95.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.42 / $106.70 / $122.36	Professional		$42.42	$106.70	$122.36
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $109.90 / $238.33	Facility		$106.70	$109.90	$238.33
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $148.65	Professional		$106.70	$106.70	$148.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $102.55 / $160.05	Professional		$37.50	$102.55	$160.05
United Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $115.00	Professional		$106.70	$106.70	$115.00