Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $438.00 / $1,609.00 / $5,389.00	Facility		$438.00	$1,609.00	$5,389.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.72 / $239.96 / $334.64	Professional		$163.72	$239.96	$334.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $478.36 / $598.55 / $736.26	Facility		$478.36	$598.55	$736.26
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $345.40 / $345.40	Professional		$120.00	$345.40	$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 Facility Modifier Low / Median / High Price $165.00 / $900.00 / $3,686.00	Facility		$165.00	$900.00	$3,686.00
United Facility/Professional Professional Modifier Low / Median / High Price $291.18 / $420.81 / $714.00	Professional		$291.18	$420.81	$714.00