Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $125.89	Facility		$63.10	$63.10	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $64.57 / $112.20	Professional		$56.23	$64.57	$112.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $239.88 / $851.14	Facility		$147.91	$239.88	$851.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $93.33	Professional		$79.43	$93.33	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $83.18	Facility		$79.43	$79.43	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $138.04	Professional		$58.88	$58.88	$138.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $173.78	Professional		$104.71	$134.90	$173.78
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 $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $93.33	Professional		$64.57	$64.57	$93.33
United Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $97.72 / $199.53	Facility		$52.48	$97.72	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $61.66 / $102.33	Professional		$47.86	$61.66	$102.33