Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.88 / $160.88 / $160.88	Facility		$160.88	$160.88	$160.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.01 / $160.88 / $247.41	Professional		$119.01	$160.88	$247.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $387.96 / $656.36 / $2,796.70	Facility		$387.96	$656.36	$2,796.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.03 / $247.03 / $247.03	Professional		$247.03	$247.03	$247.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.52 / $166.52 / $332.44	Facility		$166.52	$166.52	$332.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.56 / $166.52 / $376.88	Professional		$121.56	$166.52	$376.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $279.45 / $342.88 / $434.57	Professional		$279.45	$342.88	$434.57
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 $422.55 / $422.55 / $422.55	Professional		$422.55	$422.55	$422.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $183.50 / $262.14 / $275.25	Professional		$183.50	$262.14	$275.25
United Facility/Professional Professional Modifier Low / Median / High Price $118.89 / $162.16 / $287.14	Professional		$118.89	$162.16	$287.14