Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.19 / $893.63 / $4,500.00	Facility		$165.19	$893.63	$4,500.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.40 / $129.37 / $257.81	Professional		$91.40	$129.37	$257.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.42 / $488.84 / $1,847.24	Facility		$288.42	$488.84	$1,847.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.86 / $167.12 / $277.05	Professional		$120.86	$167.12	$277.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $159.24 / $159.24 / $177.78	Facility		$159.24	$159.24	$177.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.86 / $166.09 / $257.14	Professional		$107.86	$166.09	$257.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $130.19 / $205.73 / $456.09	Professional		$130.19	$205.73	$456.09
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 $116.96 / $126.32 / $191.04	Professional		$116.96	$126.32	$191.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $216.02	Professional		$32.34	$32.34	$216.02
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $891.00 / $3,685.00	Facility		$165.00	$891.00	$3,685.00
United Facility/Professional Professional Modifier Low / Median / High Price $127.82 / $171.16 / $291.85	Professional		$127.82	$171.16	$291.85