Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $162.18	Facility		$77.62	$77.62	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $91.20 / $162.18	Professional		$69.18	$91.20	$162.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $309.03 / $1,096.48	Facility		$190.55	$309.03	$1,096.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $213.80	Facility		$100.00	$100.00	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $186.21	Professional		$72.44	$72.44	$186.21
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $213.80 / $257.04	Professional		$134.90	$213.80	$257.04
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 $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $120.23	Professional		$85.11	$85.11	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $128.82 / $263.03	Facility		$107.15	$128.82	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $79.43 / $131.83	Professional		$66.07	$79.43	$131.83