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 $415.85 / $499.08 / $750.78	Professional		$415.85	$499.08	$750.78
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 $819.36 / $1,402.24 / $2,048.40	Professional		$819.36	$1,402.24	$2,048.40
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 $1,056.10 / $1,176.07 / $1,331.46	Professional		$1,056.10	$1,176.07	$1,331.46
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 $1,152.00 / $4,803.00 / $8,995.00	Facility		$1,152.00	$4,803.00	$8,995.00
United Facility/Professional Professional Modifier Low / Median / High Price $358.37 / $547.33 / $898.95	Professional		$358.37	$547.33	$898.95