Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $263.03	Facility		$131.83	$131.83	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $134.90 / $234.42	Professional		$109.65	$134.90	$234.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $501.19 / $1,778.28	Facility		$309.03	$501.19	$1,778.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $288.40	Facility		$169.82	$169.82	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $281.84	Professional		$123.03	$123.03	$281.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $331.13 / $398.11	Professional		$218.78	$331.13	$398.11
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 $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $158.49	Professional		$112.20	$112.20	$158.49
United Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $208.93 / $380.19	Facility		$97.72	$208.93	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $199.53	Professional		$95.50	$128.82	$199.53