Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.71 / $170.71 / $170.71	Facility		$170.71	$170.71	$170.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.52 / $170.71 / $217.45	Professional		$115.52	$170.71	$217.45
BCBS Facility/Professional Facility Modifier Low / Median / High Price $411.81 / $696.71 / $2,967.63	Facility		$411.81	$696.71	$2,967.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $262.12 / $262.12 / $326.20	Professional		$262.12	$262.12	$326.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $161.63 / $161.63 / $284.55	Facility		$161.63	$161.63	$284.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.99 / $161.63 / $399.75	Professional		$117.99	$161.63	$399.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $258.75 / $298.75 / $396.64	Professional		$258.75	$298.75	$396.64
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 $448.37 / $448.37 / $448.37	Professional		$448.37	$448.37	$448.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $259.95 / $272.95	Professional		$181.97	$259.95	$272.95
United Facility/Professional Facility Modifier Low / Median / High Price $97.44 / $170.54 / $194.44	Facility		$97.44	$170.54	$194.44
United Facility/Professional Professional Modifier Low / Median / High Price $114.71 / $170.53 / $295.38	Professional		$114.71	$170.53	$295.38