Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $117.49 / $1,023.29	Facility		$112.20	$117.49	$1,023.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $134.90	Professional		$112.20	$112.20	$134.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $208.93 / $275.42	Facility		$165.96	$208.93	$275.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $154.88	Professional		$112.20	$112.20	$154.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $190.55 / $1,148.15	Professional		$112.20	$190.55	$1,148.15
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 $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $33.11	Professional		$30.20	$30.20	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $295.12 / $295.12	Facility		$177.83	$295.12	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $812.83	Professional		$125.89	$177.83	$812.83