Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.59 / $92.59 / $92.59	Facility		$92.59	$92.59	$92.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.14 / $94.30 / $144.11	Professional		$74.14	$94.30	$144.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $237.78 / $867.37 / $1,891.84	Facility		$237.78	$867.37	$1,891.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.63 / $136.91 / $136.91	Professional		$119.63	$136.91	$136.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.53 / $116.53 / $220.78	Facility		$116.53	$116.53	$220.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.07 / $85.07 / $220.78	Professional		$85.07	$85.07	$220.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $154.25 / $199.96 / $239.75	Professional		$154.25	$199.96	$239.75
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 $234.18 / $234.18 / $234.18	Professional		$234.18	$234.18	$234.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.77 / $103.96 / $109.15	Professional		$72.77	$103.96	$109.15
United Facility/Professional Facility Modifier Low / Median / High Price $91.72 / $91.72 / $91.72	Facility		$91.72	$91.72	$91.72
United Facility/Professional Professional Modifier Low / Median / High Price $74.45 / $89.87 / $157.80	Professional		$74.45	$89.87	$157.80