Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.18 / $203.18 / $203.18	Facility		$203.18	$203.18	$203.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.37 / $203.18 / $258.81	Professional		$139.37	$203.18	$258.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $491.31 / $831.21 / $3,532.09	Facility		$491.31	$831.21	$3,532.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $311.98 / $311.98 / $311.98	Professional		$311.98	$311.98	$311.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $265.56 / $265.56 / $343.75	Facility		$265.56	$265.56	$343.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.86 / $265.56 / $475.88	Professional		$193.86	$265.56	$475.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $332.86 / $410.50 / $517.61	Professional		$332.86	$410.50	$517.61
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 $533.65 / $533.65 / $533.65	Professional		$533.65	$533.65	$533.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $216.58 / $309.41 / $324.88	Professional		$216.58	$309.41	$324.88
United Facility/Professional Professional Modifier Low / Median / High Price $137.35 / $204.80 / $351.57	Professional		$137.35	$204.80	$351.57