Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $167.28 / $218.00	Facility		$97.94	$167.28	$218.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $102.84	Professional		$97.94	$97.94	$102.84
BCBS Facility/Professional Facility Modifier Low / Median / High Price $201.60 / $308.04 / $1,526.51	Facility		$201.60	$308.04	$1,526.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.40 / $113.40 / $113.40	Professional		$113.40	$113.40	$113.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $97.94 / $97.94	Facility		$97.94	$97.94	$97.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $115.50	Professional		$97.94	$97.94	$115.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $87.41 / $137.12 / $255.06	Professional		$87.41	$137.12	$255.06
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 $127.32 / $127.32 / $127.32	Professional		$127.32	$127.32	$127.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $113.63 / $140.24 / $150.26	Professional		$113.63	$140.24	$150.26
United Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $107.38	Professional		$97.94	$97.94	$107.38