Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.36 / $53.36 / $95.02	Facility		$53.36	$53.36	$95.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.36 / $57.01 / $90.44	Professional		$30.36	$57.01	$90.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.40 / $300.02 / $1,088.89	Facility		$110.40	$300.02	$1,088.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.23 / $95.02 / $95.02	Professional		$74.23	$95.02	$95.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.77 / $38.77 / $97.47	Professional		$38.77	$38.77	$97.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $80.77 / $114.02 / $230.23	Professional		$80.77	$114.02	$230.23
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 $123.53 / $123.53 / $123.53	Professional		$123.53	$123.53	$123.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $129.22 / $133.03 / $142.53	Professional		$129.22	$133.03	$142.53
United Facility/Professional Professional Modifier Low / Median / High Price $36.18 / $47.40 / $79.00	Professional		$36.18	$47.40	$79.00