Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.28 / $232.22 / $611.48	Facility		$113.28	$232.22	$611.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.28 / $113.28 / $141.04	Professional		$113.28	$113.28	$141.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $133.34 / $348.49 / $2,043.38	Facility		$133.34	$348.49	$2,043.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.36 / $120.36 / $120.36	Facility		$120.36	$120.36	$120.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.36 / $120.36 / $120.36	Professional		$120.36	$120.36	$120.36
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.00 / $124.70 / $251.00	Professional		$112.00	$124.70	$251.00
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 $115.24 / $115.24 / $118.45	Professional		$115.24	$115.24	$118.45
United Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $118.00 / $127.44	Professional		$118.00	$118.00	$127.44