Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.75 / $74.75 / $112.62	Facility		$67.75	$74.75	$112.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.57 / $73.75 / $95.93	Professional		$59.57	$73.75	$95.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $278.79 / $745.32 / $1,443.72	Facility		$278.79	$745.32	$1,443.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.11 / $92.41 / $102.67	Professional		$87.11	$92.41	$102.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.08 / $103.82 / $143.81	Professional		$79.08	$103.82	$143.81
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.75 / $97.08 / $219.18	Professional		$67.75	$97.08	$219.18
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 $89.21 / $93.25 / $111.59	Professional		$89.21	$93.25	$111.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $80.87 / $126.18	Professional		$32.34	$80.87	$126.18
United Facility/Professional Professional Modifier Low / Median / High Price $77.67 / $109.19 / $159.66	Professional		$77.67	$109.19	$159.66