Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $168.73 / $168.73 / $168.73	Facility		$168.73	$168.73	$168.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.59 / $168.73 / $279.70	Professional		$148.59	$168.73	$279.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $407.04 / $688.64 / $2,933.23	Facility		$407.04	$688.64	$2,933.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.08 / $259.08 / $272.04	Professional		$259.08	$259.08	$272.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $220.51 / $220.51 / $372.78	Facility		$220.51	$220.51	$372.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.97 / $220.51 / $395.25	Professional		$160.97	$220.51	$395.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $292.27 / $357.96 / $454.50	Professional		$292.27	$357.96	$454.50
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 $443.18 / $443.18 / $443.18	Professional		$443.18	$443.18	$443.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $207.73 / $296.77 / $311.60	Professional		$207.73	$296.77	$311.60
United Facility/Professional Professional Modifier Low / Median / High Price $128.06 / $170.07 / $291.95	Professional		$128.06	$170.07	$291.95