Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.92 / $159.88 / $333.81	Facility		$102.92	$159.88	$333.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.90 / $102.92 / $185.40	Professional		$89.90	$102.92	$185.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $99.22 / $266.25 / $1,047.60	Facility		$99.22	$266.25	$1,047.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.57 / $124.67 / $239.00	Professional		$42.57	$124.67	$239.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.02 / $200.63 / $331.98	Facility		$104.02	$200.63	$331.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.81 / $133.38 / $198.40	Professional		$79.81	$133.38	$198.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $175.68 / $483.50	Professional		$120.00	$175.68	$483.50
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 $126.88 / $128.87 / $140.13	Professional		$126.88	$128.87	$140.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $46.27 / $146.59	Professional		$32.34	$46.27	$146.59
United Facility/Professional Facility Modifier Low / Median / High Price $128.26 / $128.26 / $180.02	Facility		$128.26	$128.26	$180.02
United Facility/Professional Professional Modifier Low / Median / High Price $89.45 / $123.67 / $202.18	Professional		$89.45	$123.67	$202.18