Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.95 / $189.95 / $189.95	Facility		$189.95	$189.95	$189.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.83 / $189.95 / $295.64	Professional		$160.83	$189.95	$295.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $442.02 / $747.82 / $3,179.77	Facility		$442.02	$747.82	$3,179.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $230.92 / $230.92 / $437.70	Facility		$230.92	$230.92	$437.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.57 / $230.92 / $428.25	Professional		$168.57	$230.92	$428.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $314.12 / $528.19 / $695.96	Professional		$314.12	$528.19	$695.96
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 $480.42 / $480.42 / $480.42	Professional		$480.42	$480.42	$480.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $208.62 / $298.04 / $312.94	Professional		$208.62	$298.04	$312.94
United Facility/Professional Professional Modifier Low / Median / High Price $152.75 / $184.37 / $317.45	Professional		$152.75	$184.37	$317.45