Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $275.42 / $426.58	Facility		$162.18	$275.42	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $229.09	Professional		$162.18	$162.18	$229.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $616.60 / $1,819.70	Facility		$245.47	$616.60	$1,819.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $190.55 / $190.55	Professional		$169.82	$190.55	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $190.55	Professional		$162.18	$162.18	$190.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $223.87 / $354.81	Professional		$154.88	$223.87	$354.81
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 $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $223.87 / $239.88	Professional		$169.82	$223.87	$239.88
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $165.96 / $251.19	Facility		$162.18	$165.96	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $169.82 / $181.97	Professional		$162.18	$169.82	$181.97