Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.64 / $59.64 / $168.20	Facility		$59.64	$59.64	$168.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.53 / $59.64 / $105.63	Professional		$49.53	$59.64	$105.63
BCBS Facility/Professional Facility Modifier Low / Median / High Price $127.20 / $264.60 / $925.03	Facility		$127.20	$264.60	$925.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.66 / $79.66 / $83.64	Professional		$79.66	$79.66	$83.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.27 / $116.27 / $116.27	Facility		$116.27	$116.27	$116.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.55 / $45.55 / $123.00	Professional		$45.55	$45.55	$123.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $106.21 / $166.07 / $216.47	Professional		$106.21	$166.07	$216.47
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 $138.07 / $138.07 / $138.07	Professional		$138.07	$138.07	$138.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $132.76 / $148.69 / $159.32	Professional		$132.76	$148.69	$159.32
United Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $52.51 / $90.96	Professional		$39.46	$52.51	$90.96