Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.71 / $813.00 / $5,405.00	Facility		$143.71	$813.00	$5,405.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.02 / $115.98 / $280.23	Professional		$64.02	$115.98	$280.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $478.95 / $728.84 / $1,485.73	Facility		$478.95	$728.84	$1,485.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.31 / $159.68 / $255.36	Professional		$87.31	$159.68	$255.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.34 / $134.51 / $251.78	Professional		$75.34	$134.51	$251.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $94.10 / $199.58 / $345.40	Professional		$94.10	$199.58	$345.40
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $88.14 / $93.29 / $204.57	Professional		$88.14	$93.29	$204.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $231.32	Professional		$32.34	$32.34	$231.32
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $1,032.00 / $3,686.00	Facility		$165.00	$1,032.00	$3,686.00
United Facility/Professional Professional Modifier Low / Median / High Price $112.37 / $179.71 / $338.25	Professional		$112.37	$179.71	$338.25