Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,548.82	Professional		$1,202.26	$1,202.26	$1,548.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,348.96 / $1,621.81	Facility		$1,202.26	$1,348.96	$1,621.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $954.99 / $1,096.48	Facility		$954.99	$954.99	$1,096.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $199.53 / $346.74	Professional		$100.00	$199.53	$346.74
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 $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $1,148.15 / $1,513.56	Facility		$933.25	$1,148.15	$1,513.56