Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $623.20 / $1,216.00 / $1,983.60	Facility		$623.20	$1,216.00	$1,983.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $585.20 / $623.20 / $684.00	Professional		$585.20	$623.20	$684.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $889.20 / $1,064.00 / $1,345.20	Facility		$889.20	$1,064.00	$1,345.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $760.00 / $760.00 / $1,155.20	Professional		$760.00	$760.00	$1,155.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $853.60 / $1,817.92 / $3,499.32	Facility		$853.60	$1,817.92	$3,499.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $912.00 / $925.90 / $1,109.33	Professional		$912.00	$925.90	$1,109.33
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $760.00 / $1,064.00 / $1,596.00	Professional		$760.00	$1,064.00	$1,596.00
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 $988.00 / $988.00 / $988.00	Professional		$988.00	$988.00	$988.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,033.59 / $1,033.59 / $1,140.00	Professional		$1,033.59	$1,033.59	$1,140.00
United Facility/Professional Professional Modifier Low / Median / High Price $319.20 / $456.00 / $782.80	Professional		$319.20	$456.00	$782.80