Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $177.83	Facility		$89.13	$89.13	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $169.82	Professional		$79.43	$100.00	$169.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $338.84 / $1,202.26	Facility		$208.93	$338.84	$1,202.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $117.49	Facility		$109.65	$109.65	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $204.17	Professional		$81.28	$81.28	$204.17
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $204.17 / $257.04	Professional		$151.36	$204.17	$257.04
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 $229.09 / $229.09 / $229.09	Professional		$229.09	$229.09	$229.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $131.83	Professional		$93.33	$93.33	$131.83
United Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $141.25 / $288.40	Facility		$74.13	$141.25	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $147.91	Professional		$69.18	$87.10	$147.91