Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.93 / $138.93 / $138.93	Facility		$138.93	$138.93	$138.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $138.93 / $138.93	Professional		$134.88	$138.93	$138.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.09 / $135.30 / $135.30	Facility		$4.09	$135.30	$135.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.54 / $140.71 / $182.66	Professional		$128.54	$140.71	$182.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $171.79	Professional		$134.88	$134.88	$171.79
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $134.88 / $134.88 / $138.93	Facility		$134.88	$134.88	$138.93
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $168.61	Professional		$134.88	$134.88	$168.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $168.61 / $205.78	Professional		$134.88	$168.61	$205.78
United Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $134.88 / $143.12	Professional		$134.88	$134.88	$143.12