Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.22 / $198.00 / $286.00	Facility		$100.22	$198.00	$286.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.11 / $100.22 / $155.34	Professional		$94.11	$100.22	$155.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $167.44 / $652.23 / $1,616.80	Facility		$167.44	$652.23	$1,616.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.50 / $84.33 / $94.11	Professional		$3.50	$84.33	$94.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $168.33 / $303.47 / $562.87	Facility		$168.33	$303.47	$562.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.54 / $148.85 / $217.50	Professional		$62.54	$148.85	$217.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $133.38 / $183.33 / $311.17	Professional		$133.38	$183.33	$311.17
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 $158.88 / $158.88 / $158.88	Professional		$158.88	$158.88	$158.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $166.22 / $166.22 / $183.33	Professional		$166.22	$166.22	$183.33
United Facility/Professional Professional Modifier Low / Median / High Price $51.33 / $73.33 / $142.72	Professional		$51.33	$73.33	$142.72