Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Facility		$20.00	$20.00	$20.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Professional		$20.00	$20.00	$20.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $111.68 / $175.00 / $320.39	Facility		$111.68	$175.00	$320.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $20.00 / $20.00	Professional		$20.00	$20.00	$20.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3.60 / $3.60 / $3.60	Professional		$3.60	$3.60	$3.60
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $58.01 / $73.19 / $160.00	Professional		$58.01	$73.19	$160.00
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $2,500.00 / $2,500.00	Professional		$1,500.00	$2,500.00	$2,500.00