Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $220.05 / $220.05 / $220.05	Facility		$220.05	$220.05	$220.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.77 / $220.05 / $364.74	Professional		$193.77	$220.05	$364.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $531.05 / $898.46 / $3,825.36	Facility		$531.05	$898.46	$3,825.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.89 / $337.89 / $337.89	Professional		$337.89	$337.89	$337.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $286.80 / $286.80 / $486.63	Facility		$286.80	$286.80	$486.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.36 / $209.36 / $546.16	Professional		$209.36	$209.36	$546.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $400.13 / $536.57 / $656.89	Professional		$400.13	$536.57	$656.89
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 $577.97 / $577.97 / $577.97	Professional		$577.97	$577.97	$577.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $270.92 / $387.04 / $406.39	Professional		$270.92	$387.04	$406.39
United Facility/Professional Professional Modifier Low / Median / High Price $198.13 / $221.80 / $392.75	Professional		$198.13	$221.80	$392.75