Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.20 / $182.31 / $504.47	Facility		$109.20	$182.31	$504.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.69 / $118.38 / $155.58	Professional		$77.69	$118.38	$155.58
BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.40 / $396.64 / $1,495.36	Facility		$229.40	$396.64	$1,495.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.95 / $151.86 / $159.21	Professional		$119.95	$151.86	$159.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $70.00 / $156.79	Facility		$60.00	$70.00	$156.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.17 / $178.60 / $279.94	Professional		$103.17	$178.60	$279.94
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $83.37 / $124.84 / $283.19	Professional		$83.37	$124.84	$283.19
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $2,429.96 / $2,429.96 / $2,429.96	Facility		$2,429.96	$2,429.96	$2,429.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.03 / $107.29 / $115.92	Professional		$104.03	$107.29	$115.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.27 / $27.00 / $2,500.00	Professional		$26.27	$27.00	$2,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $108.59 / $149.49 / $195.34	Professional		$108.59	$149.49	$195.34