Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.85 / $149.85 / $149.85	Facility		$149.85	$149.85	$149.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $149.85 / $149.85	Professional		$145.49	$149.85	$149.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4.09 / $148.22 / $148.22	Facility		$4.09	$148.22	$148.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.82 / $154.16 / $200.11	Professional		$140.82	$154.16	$200.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $161.41	Professional		$145.49	$145.49	$161.41
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $145.49 / $149.85 / $216.00	Facility		$145.49	$149.85	$216.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $174.58	Professional		$145.49	$145.49	$174.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $172.19 / $218.23	Professional		$30.00	$172.19	$218.23
United Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $145.49 / $156.81	Professional		$145.49	$145.49	$156.81