Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.99 / $331.70 / $541.08	Facility		$169.99	$331.70	$541.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.53 / $169.99 / $263.48	Professional		$142.53	$169.99	$263.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $273.64 / $871.57 / $3,021.79	Facility		$273.64	$871.57	$3,021.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.50 / $159.63 / $315.11	Professional		$4.50	$159.63	$315.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $262.98 / $506.60 / $954.49	Facility		$262.98	$506.60	$954.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.32 / $240.68 / $349.98	Professional		$96.32	$240.68	$349.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $217.68 / $338.38 / $531.97	Professional		$217.68	$338.38	$531.97
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 $269.50 / $269.50 / $269.50	Professional		$269.50	$269.50	$269.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $281.94 / $281.94 / $310.97	Professional		$281.94	$281.94	$310.97
United Facility/Professional Facility Modifier Low / Median / High Price $207.31 / $207.31 / $207.31	Facility		$207.31	$207.31	$207.31
United Facility/Professional Professional Modifier Low / Median / High Price $87.07 / $124.39 / $217.88	Professional		$87.07	$124.39	$217.88