Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.56 / $247.53 / $349.87	Facility		$124.56	$247.53	$349.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.48 / $118.77 / $187.72	Professional		$105.48	$118.77	$187.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $198.43 / $662.51 / $1,916.08	Facility		$198.43	$662.51	$1,916.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.50 / $99.94 / $111.53	Professional		$3.50	$99.94	$111.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $183.63 / $353.92 / $667.10	Facility		$183.63	$353.92	$667.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.26 / $179.08 / $263.88	Professional		$75.26	$179.08	$263.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $152.08 / $231.74 / $373.01	Professional		$152.08	$231.74	$373.01
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 $188.29 / $188.29 / $188.29	Professional		$188.29	$188.29	$188.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.99 / $196.98 / $217.26	Professional		$22.99	$196.98	$217.26
United Facility/Professional Professional Modifier Low / Median / High Price $60.83 / $94.15 / $169.14	Professional		$60.83	$94.15	$169.14