Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.36 / $62.36 / $62.36	Facility		$62.36	$62.36	$62.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.72 / $62.36 / $97.06	Professional		$54.72	$62.36	$97.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $160.15 / $584.27 / $1,274.35	Facility		$160.15	$584.27	$1,274.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.02 / $92.21 / $92.21	Professional		$77.02	$92.21	$92.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.09 / $75.09 / $132.19	Facility		$75.09	$75.09	$132.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.82 / $75.09 / $140.63	Professional		$54.82	$75.09	$140.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.20 / $140.84 / $173.67	Professional		$109.20	$140.84	$173.67
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 $157.72 / $157.72 / $157.72	Professional		$157.72	$157.72	$157.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.02 / $91.46 / $96.03	Professional		$64.02	$91.46	$96.03
United Facility/Professional Professional Modifier Low / Median / High Price $49.67 / $60.53 / $103.92	Professional		$49.67	$60.53	$103.92