Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.82 / $54.82 / $54.82	Facility		$54.82	$54.82	$54.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.28 / $54.82 / $90.87	Professional		$48.28	$54.82	$90.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.19 / $533.28 / $1,163.16	Facility		$146.19	$533.28	$1,163.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.55 / $84.18 / $84.18	Professional		$73.55	$84.18	$84.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.96 / $87.96 / $121.23	Facility		$87.96	$87.96	$121.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.77 / $87.96 / $128.25	Professional		$74.77	$87.96	$128.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $110.21 / $393.30 / $478.80	Professional		$110.21	$393.30	$478.80
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 $143.99 / $143.99 / $143.99	Professional		$143.99	$143.99	$143.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.38 / $67.69 / $71.07	Professional		$47.38	$67.69	$71.07
United Facility/Professional Professional Modifier Low / Median / High Price $42.17 / $55.25 / $115.11	Professional		$42.17	$55.25	$115.11