Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,122.62 / $5,158.51 / $6,345.25	Facility		$4,122.62	$5,158.51	$6,345.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $200.00 / $345.40	Professional		$100.00	$200.00	$345.40
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 Professional Modifier Low / Median / High Price $111.77 / $171.86 / $283.07	Professional		$111.77	$171.86	$283.07