Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $158.49	Facility		$79.43	$79.43	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $81.28 / $128.82	Professional		$63.10	$81.28	$128.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $302.00 / $1,071.52	Facility		$186.21	$302.00	$1,071.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $117.49 / $117.49	Professional		$102.33	$117.49	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $173.78	Facility		$87.10	$87.10	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $169.82	Professional		$63.10	$63.10	$169.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $154.88 / $204.17	Professional		$114.82	$154.88	$204.17
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 $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $125.89	Professional		$87.10	$87.10	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $125.89 / $223.87	Facility		$58.88	$125.89	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $77.62 / $117.49	Professional		$57.54	$77.62	$117.49