Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.88 / $115.88 / $115.88	Facility		$115.88	$115.88	$115.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.42 / $115.88 / $147.61	Professional		$78.42	$115.88	$147.61
BCBS Facility/Professional Facility Modifier Low / Median / High Price $279.83 / $473.44 / $2,014.46	Facility		$279.83	$473.44	$2,014.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.94 / $177.94 / $177.94	Professional		$177.94	$177.94	$177.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $113.00 / $113.00 / $199.13	Facility		$113.00	$113.00	$199.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.49 / $113.00 / $271.50	Professional		$82.49	$113.00	$271.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $187.30 / $231.60 / $281.39	Professional		$187.30	$231.60	$281.39
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 $304.37 / $304.37 / $304.37	Professional		$304.37	$304.37	$304.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.52 / $176.47 / $185.29	Professional		$123.52	$176.47	$185.29
United Facility/Professional Professional Modifier Low / Median / High Price $77.87 / $116.81 / $200.52	Professional		$77.87	$116.81	$200.52