Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $45.71	Facility		$25.12	$25.12	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $28.18 / $45.71	Professional		$19.05	$28.18	$45.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $97.72 / $380.19	Facility		$48.98	$97.72	$380.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.88 / $33.88	Professional		$29.51	$33.88	$33.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $28.84 / $50.12	Facility		$28.84	$28.84	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $21.38 / $50.12	Professional		$21.38	$21.38	$50.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $54.95 / $67.61	Professional		$43.65	$54.95	$67.61
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 $58.88 / $58.88 / $58.88	Professional		$58.88	$58.88	$58.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $23.99	Professional		$23.99	$23.99	$23.99
United Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $36.31 / $45.71	Facility		$22.39	$36.31	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $21.38 / $33.88	Professional		$15.85	$21.38	$33.88