Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $755.00 / $2,989.00 / $5,580.00	Facility		$755.00	$2,989.00	$5,580.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.93 / $310.47 / $394.10	Professional		$209.93	$310.47	$394.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $12,545.66 / $15,697.99 / $19,309.40	Facility		$12,545.66	$15,697.99	$19,309.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $345.40 / $534.41 / $784.52	Professional		$345.40	$534.41	$784.52
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 $408.67 / $450.66 / $509.94	Professional		$408.67	$450.66	$509.94
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 $2,276.00 / $8,141.00 / $21,651.00	Facility		$2,276.00	$8,141.00	$21,651.00
United Facility/Professional Professional Modifier Low / Median / High Price $344.47 / $489.78 / $852.82	Professional		$344.47	$489.78	$852.82