Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.95 / $91.23 / $297.89	Facility		$39.95	$91.23	$297.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.94 / $39.95 / $93.00	Professional		$21.94	$39.95	$93.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $84.27 / $179.73 / $623.55	Facility		$84.27	$179.73	$623.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.70 / $53.36 / $53.36	Professional		$33.70	$53.36	$53.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.91 / $44.91 / $77.84	Facility		$44.91	$44.91	$77.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.17 / $44.91 / $82.50	Professional		$38.17	$44.91	$82.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $67.59 / $90.01 / $132.85	Professional		$67.59	$90.01	$132.85
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 $92.50 / $92.50 / $92.50	Professional		$92.50	$92.50	$92.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $88.94 / $99.61 / $106.73	Professional		$88.94	$99.61	$106.73
United Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $35.50 / $60.93	Professional		$26.26	$35.50	$60.93