Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $117.49 / $1,737.80	Facility		$109.65	$117.49	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $131.83	Professional		$109.65	$109.65	$131.83
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 $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $154.88	Professional		$109.65	$109.65	$154.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $199.53 / $549.54	Professional		$109.65	$199.53	$549.54
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 $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
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 $204.17 / $338.84 / $338.84	Facility		$204.17	$338.84	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $204.17 / $1,659.59	Professional		$125.89	$204.17	$1,659.59