Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.22 / $62.22 / $62.22	Facility		$62.22	$62.22	$62.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.63 / $62.22 / $96.85	Professional		$48.63	$62.22	$96.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.69 / $244.79 / $1,041.57	Facility		$144.69	$244.79	$1,041.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.03 / $92.01 / $92.01	Professional		$78.03	$92.01	$92.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.30 / $81.30 / $132.51	Facility		$81.30	$81.30	$132.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.35 / $81.30 / $140.25	Professional		$59.35	$81.30	$140.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $111.54 / $139.33 / $171.51	Professional		$111.54	$139.33	$171.51
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 $157.38 / $157.38 / $157.38	Professional		$157.38	$157.38	$157.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $73.77 / $105.39 / $110.65	Professional		$73.77	$105.39	$110.65
United Facility/Professional Professional Modifier Low / Median / High Price $44.96 / $60.40 / $103.68	Professional		$44.96	$60.40	$103.68