Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.09 / $270.57 / $455.79	Facility		$143.09	$270.57	$455.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.21 / $152.40 / $342.88	Professional		$127.21	$152.40	$342.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $662.54 / $1,128.59 / $3,963.45	Facility		$662.54	$1,128.59	$3,963.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.59 / $175.86 / $337.11	Professional		$91.59	$175.86	$337.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $145.85 / $266.20 / $804.68	Facility		$145.85	$266.20	$804.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.01 / $231.46 / $652.35	Professional		$131.01	$231.46	$652.35
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $167.88 / $275.33 / $1,154.50	Professional		$167.88	$275.33	$1,154.50
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 $175.31 / $178.97 / $197.51	Professional		$175.31	$178.97	$197.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $94.84 / $206.62	Professional		$32.34	$94.84	$206.62
United Facility/Professional Facility Modifier Low / Median / High Price $3,574.76 / $3,574.76 / $4,226.43	Facility		$3,574.76	$3,574.76	$4,226.43
United Facility/Professional Professional Modifier Low / Median / High Price $160.60 / $252.56 / $560.98	Professional		$160.60	$252.56	$560.98