Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.25 / $47.25 / $47.25	Facility		$47.25	$47.25	$47.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.94 / $47.25 / $73.54	Professional		$36.94	$47.25	$73.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.71 / $185.61 / $791.04	Facility		$109.71	$185.61	$791.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.25 / $69.87 / $69.87	Professional		$59.25	$69.87	$69.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.32 / $51.32 / $100.64	Facility		$51.32	$51.32	$100.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.46 / $51.32 / $106.50	Professional		$37.46	$51.32	$106.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $91.51 / $113.99 / $138.59	Professional		$91.51	$113.99	$138.59
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 $119.51 / $119.51 / $119.51	Professional		$119.51	$119.51	$119.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.51 / $69.30 / $72.76	Professional		$48.51	$69.30	$72.76
United Facility/Professional Professional Modifier Low / Median / High Price $37.21 / $45.86 / $81.20	Professional		$37.21	$45.86	$81.20