Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $117.49 / $1,737.80	Facility		$89.13	$117.49	$1,737.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $112.20	Professional		$89.13	$89.13	$112.20
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 $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $93.33	Professional		$89.13	$89.13	$93.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $102.33 / $165.96	Professional		$79.43	$102.33	$165.96
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 $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
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 $72.44 / $117.49 / $117.49	Facility		$72.44	$117.49	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $128.82 / $1,659.59	Professional		$107.15	$128.82	$1,659.59