Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.69 / $85.69 / $85.69	Facility		$85.69	$85.69	$85.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $85.69 / $121.93	Professional		$65.88	$85.69	$121.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $198.75 / $336.25 / $1,434.51	Facility		$198.75	$336.25	$1,434.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.02 / $126.71 / $126.71	Professional		$105.02	$126.71	$126.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.94 / $112.36 / $183.56	Facility		$111.94	$112.36	$183.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.02 / $112.36 / $193.13	Professional		$82.02	$112.36	$193.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $126.35 / $166.87 / $206.75	Professional		$126.35	$166.87	$206.75
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 $216.75 / $216.75 / $216.75	Professional		$216.75	$216.75	$216.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.96 / $125.66 / $131.94	Professional		$87.96	$125.66	$131.94
United Facility/Professional Professional Modifier Low / Median / High Price $56.21 / $82.43 / $147.28	Professional		$56.21	$82.43	$147.28