Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.00 / $262.50 / $380.70	Facility		$123.00	$262.50	$380.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.50 / $123.00 / $190.65	Professional		$115.50	$123.00	$190.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $202.50 / $648.37 / $1,984.29	Facility		$202.50	$648.37	$1,984.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $4.50 / $115.50 / $228.00	Professional		$4.50	$115.50	$228.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $196.51 / $333.76 / $690.93	Facility		$196.51	$333.76	$690.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.12 / $182.99 / $253.34	Professional		$73.12	$182.99	$253.34
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.00 / $262.50 / $609.47	Professional		$165.00	$262.50	$609.47
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 $195.00 / $195.00 / $195.00	Professional		$195.00	$195.00	$195.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.99 / $204.00 / $225.00	Professional		$22.99	$204.00	$225.00
United Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $90.00 / $150.00	Professional		$63.00	$90.00	$150.00