Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $137.77 / $472.50	Facility		$131.90	$137.77	$472.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $138.49	Professional		$131.90	$131.90	$138.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $338.40 / $517.07 / $2,562.36	Facility		$338.40	$517.07	$2,562.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.31 / $151.31 / $186.66	Professional		$151.31	$151.31	$186.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $131.90 / $131.90	Facility		$131.90	$131.90	$131.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $158.16	Professional		$131.90	$131.90	$158.16
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.12 / $180.00 / $402.85	Professional		$112.12	$180.00	$402.85
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 $171.47 / $171.47 / $171.47	Professional		$171.47	$171.47	$171.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.90 / $187.12 / $200.49	Professional		$109.90	$187.12	$200.49
United Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $144.61	Professional		$131.90	$131.90	$144.61