Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.48 / $69.48 / $69.48	Facility		$69.48	$69.48	$69.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.67 / $69.48 / $100.50	Professional		$51.67	$69.48	$100.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $274.38 / $1,163.08	Facility		$162.18	$274.38	$1,163.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.42 / $87.42 / $111.52	Facility		$87.42	$87.42	$111.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.82 / $87.42 / $156.75	Professional		$63.82	$87.42	$156.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $101.61 / $135.16 / $175.72	Professional		$101.61	$135.16	$175.72
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 $175.72 / $175.72 / $175.72	Professional		$175.72	$175.72	$175.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.31 / $101.88 / $106.97	Professional		$71.31	$101.88	$106.97
United Facility/Professional Professional Modifier Low / Median / High Price $42.36 / $64.62 / $119.41	Professional		$42.36	$64.62	$119.41