Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,216.63 / $9,145.75 / $11,816.04	Facility		$4,216.63	$9,145.75	$11,816.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $346.54 / $588.80 / $866.34	Professional		$346.54	$588.80	$866.34
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 $450.27 / $497.28 / $563.12	Professional		$450.27	$497.28	$563.12
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 $411.92 / $683.99 / $1,129.56	Professional		$411.92	$683.99	$1,129.56