Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $869.90 / $2,265.00 / $5,430.00	Facility		$869.90	$2,265.00	$5,430.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $869.90 / $1,308.57 / $2,327.07	Professional		$869.90	$1,308.57	$2,327.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,900.40 / $4,494.99 / $5,807.40	Facility		$2,900.40	$4,494.99	$5,807.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $200.00 / $345.40	Professional		$100.00	$200.00	$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 $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 $2,017.64 / $2,929.20 / $4,299.10	Professional		$2,017.64	$2,929.20	$4,299.10