Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.29 / $71.29 / $71.29	Facility		$71.29	$71.29	$71.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.32 / $71.29 / $125.78	Professional		$56.32	$71.29	$125.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $171.72 / $290.52 / $1,239.39	Facility		$171.72	$290.52	$1,239.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.47 / $109.47 / $109.47	Professional		$109.47	$109.47	$109.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.25 / $99.25 / $153.10	Facility		$99.25	$99.25	$153.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $72.45 / $168.54	Professional		$72.45	$72.45	$168.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $136.84 / $169.92 / $205.28	Professional		$136.84	$169.92	$205.28
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 $187.25 / $187.25 / $187.25	Professional		$187.25	$187.25	$187.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.99 / $108.57 / $113.99	Professional		$75.99	$108.57	$113.99
United Facility/Professional Facility Modifier Low / Median / High Price $47.16 / $82.54 / $94.11	Facility		$47.16	$82.54	$94.11
United Facility/Professional Professional Modifier Low / Median / High Price $52.31 / $71.86 / $123.36	Professional		$52.31	$71.86	$123.36