Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $198.72 / $198.72 / $198.72	Facility		$198.72	$198.72	$198.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.45 / $202.40 / $323.33	Professional		$170.45	$202.40	$323.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $625.46 / $1,861.67 / $4,060.54	Facility		$625.46	$1,861.67	$4,060.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $382.03 / $382.03 / $513.27	Facility		$382.03	$382.03	$513.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.88 / $299.85 / $426.00	Professional		$278.88	$299.85	$426.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $318.17 / $586.44 / $816.61	Professional		$318.17	$586.44	$816.61
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 $413.62 / $413.62 / $413.62	Professional		$413.62	$413.62	$413.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $245.07 / $350.10 / $367.60	Professional		$245.07	$350.10	$367.60
United Facility/Professional Professional Modifier Low / Median / High Price $214.69 / $285.80 / $490.63	Professional		$214.69	$285.80	$490.63