Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.96 / $58.96 / $58.96	Facility		$58.96	$58.96	$58.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.91 / $58.96 / $83.28	Professional		$42.91	$58.96	$83.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.74 / $231.34 / $987.09	Facility		$136.74	$231.34	$987.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.50 / $87.19 / $87.19	Professional		$60.50	$87.19	$87.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.00 / $81.37 / $109.22	Facility		$77.00	$81.37	$109.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.40 / $81.37 / $133.13	Professional		$59.40	$81.37	$133.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $175.59 / $231.37	Professional		$100.00	$175.59	$231.37
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 $149.13 / $149.13 / $149.13	Professional		$149.13	$149.13	$149.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.52 / $86.47 / $90.79	Professional		$60.52	$86.47	$90.79
United Facility/Professional Professional Modifier Low / Median / High Price $38.15 / $55.91 / $98.25	Professional		$38.15	$55.91	$98.25