Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $166.47 / $166.47 / $166.47	Facility		$166.47	$166.47	$166.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $166.47 / $166.47	Professional		$161.62	$166.47	$166.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.70 / $75.70 / $75.70	Facility		$75.70	$75.70	$75.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.92 / $78.73 / $102.20	Professional		$71.92	$78.73	$102.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $191.06	Professional		$161.62	$161.62	$191.06
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $166.47 / $275.94	Facility		$161.62	$166.47	$275.94
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $193.94	Professional		$161.62	$161.62	$193.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $242.43 / $253.38	Professional		$30.00	$242.43	$253.38
United Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $174.19	Professional		$161.62	$161.62	$174.19