Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $755.00 / $1,691.05 / $5,430.00	Facility		$755.00	$1,691.05	$5,430.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $553.14 / $722.60 / $1,312.88	Professional		$553.14	$722.60	$1,312.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,430.97 / $5,884.74 / $12,835.38	Facility		$3,430.97	$5,884.74	$12,835.38
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 $584.11 / $929.59 / $1,478.44	Professional		$584.11	$929.59	$1,478.44
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $693.55 / $1,145.08 / $1,661.77	Professional		$693.55	$1,145.08	$1,661.77
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 $800.42 / $819.92 / $1,127.02	Professional		$800.42	$819.92	$1,127.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,300.41	Professional		$32.34	$32.34	$1,300.41
United Facility/Professional Facility Modifier Low / Median / High Price $1,600.00 / $3,951.00 / $6,625.00	Facility		$1,600.00	$3,951.00	$6,625.00
United Facility/Professional Professional Modifier Low / Median / High Price $767.98 / $1,055.97 / $1,862.34	Professional		$767.98	$1,055.97	$1,862.34