Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.11 / $221.93 / $221.93	Facility		$143.11	$221.93	$221.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.81 / $143.11 / $190.21	Professional		$126.81	$143.11	$190.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $428.48 / $1,481.17 / $3,445.64	Facility		$428.48	$1,481.17	$3,445.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.22 / $239.43 / $297.19	Professional		$155.22	$239.43	$297.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $157.91 / $454.27 / $869.17	Facility		$157.91	$454.27	$869.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.97 / $193.16 / $306.73	Professional		$139.97	$193.16	$306.73
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $139.46 / $206.80 / $466.68	Professional		$139.46	$206.80	$466.68
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 $164.07 / $170.96 / $181.96	Professional		$164.07	$170.96	$181.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $205.76	Professional		$32.34	$32.34	$205.76
United Facility/Professional Professional Modifier Low / Median / High Price $133.12 / $181.52 / $284.08	Professional		$133.12	$181.52	$284.08