Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $839.66 / $2,118.00 / $5,389.00	Facility		$839.66	$2,118.00	$5,389.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $789.24 / $1,296.61 / $2,385.69	Professional		$789.24	$1,296.61	$2,385.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,656.41 / $8,179.84 / $17,841.27	Facility		$4,656.41	$8,179.84	$17,841.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,064.76 / $1,560.90 / $2,330.80	Professional		$1,064.76	$1,560.90	$2,330.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $875.00 / $908.00	Facility		$875.00	$875.00	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $944.54 / $1,536.28 / $2,392.64	Professional		$944.54	$1,536.28	$2,392.64
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,050.40 / $2,005.81 / $4,957.56	Professional		$1,050.40	$2,005.81	$4,957.56
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 $1,088.79 / $1,132.83 / $1,862.54	Professional		$1,088.79	$1,132.83	$1,862.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $2,149.08	Professional		$32.34	$32.34	$2,149.08
United Facility/Professional Facility Modifier Low / Median / High Price $1,600.00 / $5,000.00 / $8,995.00	Facility		$1,600.00	$5,000.00	$8,995.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,348.88 / $1,906.57 / $3,267.46	Professional		$1,348.88	$1,906.57	$3,267.46