Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $147.91 / $338.84	Facility		$112.20	$147.91	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $177.83	Professional		$83.18	$112.20	$177.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $371.54 / $1,412.54	Facility		$204.17	$371.54	$1,412.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $72.44 / $190.55	Professional		$22.91	$72.44	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $223.87 / $467.74	Facility		$91.20	$223.87	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $208.93	Professional		$89.13	$131.83	$208.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $229.09 / $549.54	Professional		$120.23	$229.09	$549.54
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 $131.83 / $134.90 / $147.91	Professional		$131.83	$134.90	$147.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $199.53 / $630.96	Facility		$70.79	$199.53	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $194.98	Professional		$93.33	$125.89	$194.98