Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.78 / $223.78 / $223.78	Facility		$223.78	$223.78	$223.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.70 / $223.78 / $337.73	Professional		$172.70	$223.78	$337.73
BCBS Facility/Professional Facility Modifier Low / Median / High Price $540.60 / $914.60 / $3,890.16	Facility		$540.60	$914.60	$3,890.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $343.62 / $343.62 / $343.62	Professional		$343.62	$343.62	$343.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $292.48 / $292.48 / $501.08	Facility		$292.48	$292.48	$501.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.51 / $292.48 / $524.25	Professional		$213.51	$292.48	$524.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $368.46 / $452.13 / $572.97	Professional		$368.46	$452.13	$572.97
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 $587.77 / $587.77 / $587.77	Professional		$587.77	$587.77	$587.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $238.54 / $340.78 / $357.81	Professional		$238.54	$340.78	$357.81
United Facility/Professional Professional Modifier Low / Median / High Price $152.06 / $225.56 / $387.22	Professional		$152.06	$225.56	$387.22