Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.55 / $200.97 / $253.77	Facility		$103.55	$200.97	$253.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.92 / $108.80 / $197.26	Professional		$91.92	$108.80	$197.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.26 / $433.09 / $1,199.57	Facility		$128.26	$433.09	$1,199.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.57 / $125.43 / $203.29	Professional		$42.57	$125.43	$203.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.65 / $246.98 / $692.47	Facility		$164.65	$246.98	$692.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.54 / $146.41 / $254.96	Professional		$83.54	$146.41	$254.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $119.30 / $174.56 / $615.36	Professional		$119.30	$174.56	$615.36
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 $127.65 / $129.68 / $140.99	Professional		$127.65	$129.68	$140.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $46.27 / $147.49	Professional		$32.34	$46.27	$147.49
United Facility/Professional Facility Modifier Low / Median / High Price $694.20 / $694.20 / $992.02	Facility		$694.20	$694.20	$992.02
United Facility/Professional Professional Modifier Low / Median / High Price $109.08 / $143.37 / $238.85	Professional		$109.08	$143.37	$238.85