Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.84 / $102.84 / $102.84	Facility		$102.84	$102.84	$102.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.37 / $97.94 / $102.84	Professional		$87.37	$97.94	$102.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $84.89 / $161.47 / $252.38	Facility		$84.89	$161.47	$252.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $170.83 / $225.49	Professional		$97.94	$170.83	$225.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.40 / $97.94 / $97.94	Facility		$92.40	$97.94	$97.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $97.94	Professional		$97.94	$97.94	$97.94
Medcost Facility/Professional Facility Modifier Low / Median / High Price $75.87 / $113.12 / $206.40	Facility		$75.87	$113.12	$206.40
Medcost Facility/Professional Professional Modifier Low / Median / High Price $75.87 / $75.87 / $75.87	Professional		$75.87	$75.87	$75.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $90.10 / $97.94 / $107.73	Professional		$90.10	$97.94	$107.73