Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.40 / $95.40 / $95.40	Facility		$95.40	$95.40	$95.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.23 / $95.40 / $148.47	Professional		$77.23	$95.40	$148.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $221.01 / $373.91 / $1,596.99	Facility		$221.01	$373.91	$1,596.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.75 / $141.06 / $141.06	Professional		$108.75	$141.06	$141.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.06 / $120.06 / $193.52	Facility		$120.06	$120.06	$193.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.64 / $120.06 / $215.25	Professional		$87.64	$120.06	$215.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $162.21 / $210.55 / $259.64	Professional		$162.21	$210.55	$259.64
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 $241.28 / $241.28 / $241.28	Professional		$241.28	$241.28	$241.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.92 / $139.88 / $146.88	Professional		$97.92	$139.88	$146.88
United Facility/Professional Professional Modifier Low / Median / High Price $70.52 / $92.59 / $163.95	Professional		$70.52	$92.59	$163.95