Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $138.04 / $162.18	Facility		$125.89	$138.04	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $87.10 / $162.18	Professional		$67.61	$87.10	$162.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $467.74 / $1,621.81	Facility		$275.42	$467.74	$1,621.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $117.49 / $162.18	Professional		$95.50	$117.49	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $128.82 / $208.93	Professional		$87.10	$128.82	$208.93
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $144.54 / $331.13	Professional		$91.20	$144.54	$331.13
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 $102.33 / $104.71 / $134.90	Professional		$102.33	$104.71	$134.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $151.36 / $165.96	Professional		$39.81	$151.36	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $177.83	Professional		$83.18	$114.82	$177.83