Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.25 / $83.25 / $83.25	Facility		$83.25	$83.25	$83.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.74 / $83.25 / $116.18	Professional		$57.74	$83.25	$116.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.98 / $328.18 / $1,393.53	Facility		$193.98	$328.18	$1,393.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.56 / $123.10 / $123.10	Professional		$107.56	$123.10	$123.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.22 / $106.22 / $148.94	Facility		$106.22	$106.22	$148.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.54 / $106.22 / $187.88	Professional		$77.54	$106.22	$187.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $130.97 / $172.57 / $201.39	Professional		$130.97	$172.57	$201.39
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 $210.56 / $210.56 / $210.56	Professional		$210.56	$210.56	$210.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.45 / $122.08 / $128.18	Professional		$85.45	$122.08	$128.18
United Facility/Professional Facility Modifier Low / Median / High Price $49.98 / $65.59 / $75.06	Facility		$49.98	$65.59	$75.06
United Facility/Professional Professional Modifier Low / Median / High Price $55.16 / $80.08 / $141.88	Professional		$55.16	$80.08	$141.88