Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.88 / $2,989.00 / $5,549.00	Facility		$253.88	$2,989.00	$5,549.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.88 / $384.49 / $468.24	Professional		$253.88	$384.49	$468.24
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,752.12 / $2,466.36 / $5,003.60	Facility		$1,752.12	$2,466.36	$5,003.60
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 $557.00 / $2,873.00 / $6,625.00	Facility		$557.00	$2,873.00	$6,625.00
United Facility/Professional Professional Modifier Low / Median / High Price $419.21 / $602.46 / $963.79	Professional		$419.21	$602.46	$963.79