Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.58 / $123.90 / $272.95	Facility		$104.58	$123.90	$272.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $90.24 / $126.76	Professional		$89.34	$90.24	$126.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $206.79 / $677.44 / $1,485.62	Facility		$206.79	$677.44	$1,485.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.00 / $160.22 / $180.95	Professional		$114.00	$160.22	$180.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.34 / $89.34 / $89.34	Facility		$89.34	$89.34	$89.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $139.79	Professional		$89.34	$89.34	$139.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $154.19 / $312.88	Professional		$89.34	$154.19	$312.88
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 $116.14 / $116.14 / $116.14	Professional		$116.14	$116.14	$116.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.75 / $166.25 / $178.13	Professional		$118.75	$166.25	$178.13
United Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $94.70 / $113.73	Professional		$89.34	$94.70	$113.73