Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $117.49 / $501.19	Facility		$112.20	$117.49	$501.19
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
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 / $158.49	Professional		$112.20	$112.20	$158.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $199.53 / $537.03	Professional		$112.20	$199.53	$537.03
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 $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $549.54 / $549.54	Facility		$331.13	$549.54	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $309.03 / $398.11	Professional		$125.89	$309.03	$398.11