Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.29 / $69.29 / $69.29	Facility		$69.29	$69.29	$69.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $69.29 / $69.29	Professional		$67.27	$69.29	$69.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.95 / $189.91 / $378.54	Facility		$122.95	$189.91	$378.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.11 / $71.28 / $92.53	Professional		$65.11	$71.28	$92.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.69 / $67.27 / $71.97	Professional		$58.69	$67.27	$71.97
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $67.27 / $69.29 / $100.91	Facility		$67.27	$69.29	$100.91
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $67.27 / $80.72	Professional		$67.27	$67.27	$80.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $95.43 / $100.90	Professional		$30.00	$95.43	$100.90
United Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $67.27 / $72.50	Professional		$67.27	$67.27	$72.50