Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.65 / $167.65 / $220.04	Facility		$167.65	$167.65	$220.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.65 / $167.65 / $178.13	Professional		$167.65	$167.65	$178.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $403.97 / $617.27 / $3,058.89	Facility		$403.97	$617.27	$3,058.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.13 / $178.13 / $178.13	Facility		$178.13	$178.13	$178.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.13 / $178.13 / $178.13	Professional		$178.13	$178.13	$178.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $200.00 / $345.40	Professional		$120.00	$200.00	$345.40
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $40.00 / $2,500.00	Professional		$30.00	$40.00	$2,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $202.90 / $202.90 / $222.45	Professional		$202.90	$202.90	$222.45