Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.11 / $213.89 / $318.99	Facility		$105.11	$213.89	$318.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.33 / $105.11 / $208.38	Professional		$95.33	$105.11	$208.38
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 $154.96 / $298.50 / $562.87	Facility		$154.96	$298.50	$562.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.51 / $151.13 / $222.65	Professional		$63.51	$151.13	$222.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $128.33 / $213.89 / $509.10	Professional		$128.33	$213.89	$509.10
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 $22.99 / $166.22 / $183.33	Professional		$22.99	$166.22	$183.33
United Facility/Professional Facility Modifier Low / Median / High Price $122.22 / $122.22 / $122.22	Facility		$122.22	$122.22	$122.22
United Facility/Professional Professional Modifier Low / Median / High Price $51.33 / $82.99 / $142.72	Professional		$51.33	$82.99	$142.72