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 $138.86 / $297.04 / $594.82	Facility		$138.86	$297.04	$594.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.55 / $35.84 / $35.84	Professional		$31.55	$35.84	$35.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.70 / $18.70 / $18.70	Professional		$18.70	$18.70	$18.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $80.80 / $118.70 / $160.00	Professional		$80.80	$118.70	$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 $16.84 / $30.00 / $2,500.00	Professional		$16.84	$30.00	$2,500.00