Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $295.12 / $457.09	Facility		$173.78	$295.12	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $281.84	Professional		$173.78	$173.78	$281.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $645.65 / $1,905.46	Facility		$263.03	$645.65	$1,905.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $199.53 / $199.53	Professional		$177.83	$199.53	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $218.78	Professional		$173.78	$173.78	$218.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $257.04 / $407.38	Professional		$165.96	$257.04	$407.38
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 $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $239.88 / $257.04	Professional		$177.83	$239.88	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $269.15	Facility		$173.78	$173.78	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $181.97 / $194.98	Professional		$173.78	$181.97	$194.98