Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $735.00 / $1,544.00 / $5,389.00	Facility		$735.00	$1,544.00	$5,389.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $632.89 / $729.02 / $1,298.74	Professional		$632.89	$729.02	$1,298.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,741.57 / $10,142.40 / $20,310.15	Facility		$4,741.57	$10,142.40	$20,310.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $923.44 / $1,276.91 / $1,557.85	Professional		$923.44	$1,276.91	$1,557.85
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 $771.43 / $1,112.97 / $1,566.40	Professional		$771.43	$1,112.97	$1,566.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $862.11 / $1,298.75 / $3,678.12	Professional		$862.11	$1,298.75	$3,678.12
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 $860.81 / $964.78 / $1,071.75	Professional		$860.81	$964.78	$1,071.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,211.90	Professional		$32.34	$32.34	$1,211.90
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $891.00 / $3,685.00	Facility		$165.00	$891.00	$3,685.00
United Facility/Professional Professional Modifier Low / Median / High Price $684.64 / $956.08 / $1,612.02	Professional		$684.64	$956.08	$1,612.02