Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $165.96	Facility		$83.18	$83.18	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $83.18 / $131.83	Professional		$60.26	$83.18	$131.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $316.23 / $1,122.02	Facility		$194.98	$316.23	$1,122.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $123.03 / $123.03	Professional		$107.15	$123.03	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $109.65	Facility		$107.15	$107.15	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $165.96	Professional		$77.62	$77.62	$165.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $165.96 / $229.09	Professional		$131.83	$165.96	$229.09
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 $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $123.03	Professional		$85.11	$85.11	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $128.82 / $218.78	Facility		$56.23	$128.82	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $81.28 / $114.82	Professional		$54.95	$81.28	$114.82