Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.76 / $71.76 / $443.18	Facility		$71.76	$71.76	$443.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $71.76 / $121.88	Professional		$63.10	$71.76	$121.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.31 / $293.20 / $1,247.49	Facility		$173.31	$293.20	$1,247.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.61 / $110.19 / $110.19	Professional		$107.61	$110.19	$110.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.00 / $128.85 / $159.49	Facility		$126.00	$128.85	$159.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.52 / $117.38 / $168.00	Professional		$109.52	$117.38	$168.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $137.74 / $182.50 / $222.79	Professional		$137.74	$182.50	$222.79
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 $188.49 / $188.49 / $188.49	Professional		$188.49	$188.49	$188.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.49 / $77.84 / $81.74	Professional		$54.49	$77.84	$81.74
United Facility/Professional Professional Modifier Low / Median / High Price $60.58 / $72.34 / $128.08	Professional		$60.58	$72.34	$128.08