Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.26 / $61.26 / $61.26	Facility		$61.26	$61.26	$61.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.20 / $61.26 / $104.86	Professional		$49.20	$61.26	$104.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.87 / $249.24 / $1,064.93	Facility		$147.87	$249.24	$1,064.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.06 / $94.06 / $94.06	Professional		$94.06	$94.06	$94.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.84 / $68.84 / $150.78	Facility		$68.84	$68.84	$150.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.25 / $50.25 / $150.78	Professional		$50.25	$50.25	$150.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $115.70 / $140.53 / $179.45	Professional		$115.70	$140.53	$179.45
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 $160.88 / $160.88 / $160.88	Professional		$160.88	$160.88	$160.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.41 / $107.74 / $113.12	Professional		$75.41	$107.74	$113.12
United Facility/Professional Professional Modifier Low / Median / High Price $46.03 / $61.74 / $106.23	Professional		$46.03	$61.74	$106.23