Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.55 / $3,073.00 / $5,549.00	Facility		$113.55	$3,073.00	$5,549.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.55 / $175.88 / $308.45	Professional		$113.55	$175.88	$308.45
BCBS Facility/Professional Facility Modifier Low / Median / High Price $287.56 / $343.07 / $442.60	Facility		$287.56	$343.07	$442.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.93 / $507.57 / $507.57	Professional		$416.93	$507.57	$507.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.87 / $250.87 / $280.07	Facility		$250.87	$250.87	$280.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.34 / $416.18 / $616.75	Professional		$247.34	$416.18	$616.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $359.58 / $525.62 / $813.53	Professional		$359.58	$525.62	$813.53
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $2,500.00 / $2,500.00	Professional		$1,500.00	$2,500.00	$2,500.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,600.00 / $4,530.00 / $8,566.00	Facility		$1,600.00	$4,530.00	$8,566.00
United Facility/Professional Professional Modifier Low / Median / High Price $255.84 / $361.78 / $581.04	Professional		$255.84	$361.78	$581.04