Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.78 / $52.78 / $52.78	Facility		$52.78	$52.78	$52.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.26 / $52.78 / $69.42	Professional		$41.26	$52.78	$69.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.43 / $207.13 / $883.55	Facility		$122.43	$207.13	$883.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.18 / $78.04 / $78.04	Professional		$66.18	$78.04	$78.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.32 / $57.32 / $112.40	Facility		$57.32	$57.32	$112.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.84 / $41.84 / $120.06	Professional		$41.84	$41.84	$120.06
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.48 / $126.88 / $152.19	Professional		$100.48	$126.88	$152.19
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 $133.50 / $133.50 / $133.50	Professional		$133.50	$133.50	$133.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.18 / $77.41 / $81.28	Professional		$54.18	$77.41	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $102.69 / $146.78 / $272.77	Facility		$102.69	$146.78	$272.77
United Facility/Professional Professional Modifier Low / Median / High Price $38.14 / $51.23 / $90.72	Professional		$38.14	$51.23	$90.72