Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $123.03 / $213.80	Facility		$81.28	$123.03	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $109.65	Professional		$81.28	$81.28	$109.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $229.09 / $1,258.93	Facility		$123.03	$229.09	$1,258.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $95.50	Professional		$85.11	$85.11	$95.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $95.50	Professional		$81.28	$81.28	$95.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $169.82 / $245.47	Professional		$81.28	$169.82	$245.47
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 $107.15 / $107.15 / $107.15	Professional		$107.15	$107.15	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $81.28 / $112.20	Professional		$79.43	$81.28	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $125.89	Facility		$81.28	$81.28	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $85.11 / $91.20	Professional		$81.28	$85.11	$91.20