Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.86 / $114.32 / $210.58	Facility		$62.86	$114.32	$210.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.60 / $58.21 / $67.56	Professional		$45.60	$58.21	$67.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.80 / $245.08 / $1,484.56	Facility		$100.80	$245.08	$1,484.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.37 / $98.44 / $110.87	Professional		$80.37	$98.44	$110.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4.63 / $160.13 / $276.74	Facility		$4.63	$160.13	$276.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.61 / $51.43 / $89.54	Professional		$24.61	$51.43	$89.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $54.44 / $79.18 / $186.71	Professional		$54.44	$79.18	$186.71
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 $64.34 / $65.55 / $70.20	Professional		$64.34	$65.55	$70.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.85 / $25.70 / $2,500.00	Professional		$12.85	$25.70	$2,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $25.82 / $33.20 / $67.01	Professional		$25.82	$33.20	$67.01