Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $826.00 / $1,972.00 / $5,389.00	Facility		$826.00	$1,972.00	$5,389.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $824.65 / $1,007.26 / $1,910.04	Professional		$824.65	$1,007.26	$1,910.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,202.15 / $11,138.18 / $24,293.79	Facility		$2,202.15	$11,138.18	$24,293.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,239.89 / $1,714.48 / $2,066.32	Professional		$1,239.89	$1,714.48	$2,066.32
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 $1,007.79 / $1,489.57 / $2,205.87	Professional		$1,007.79	$1,489.57	$2,205.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,113.55 / $1,722.63 / $4,717.62	Professional		$1,113.55	$1,722.63	$4,717.62
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 $1,095.16 / $1,279.67 / $1,439.01	Professional		$1,095.16	$1,279.67	$1,439.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,627.19	Professional		$32.34	$32.34	$1,627.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,499.00 / $3,671.00 / $6,514.00	Facility		$1,499.00	$3,671.00	$6,514.00
United Facility/Professional Professional Modifier Low / Median / High Price $961.54 / $1,369.31 / $2,274.33	Professional		$961.54	$1,369.31	$2,274.33