Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $438.00 / $1,169.00 / $4,634.00	Facility		$438.00	$1,169.00	$4,634.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $228.69 / $397.65 / $474.77	Facility	54	$228.69	$397.65	$474.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.71 / $301.69 / $541.09	Professional		$252.71	$301.69	$541.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $3,268.96 / $7,130.03	Facility		$330.07	$3,268.96	$7,130.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $366.02 / $506.11 / $639.61	Professional		$366.02	$506.11	$639.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.87 / $280.07 / $480.00	Facility		$250.87	$280.07	$480.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.61 / $439.74 / $640.12	Professional		$290.61	$439.74	$640.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $335.17 / $499.85 / $1,097.33	Professional		$335.17	$499.85	$1,097.33
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 $355.39 / $380.00 / $442.87	Professional		$355.39	$380.00	$442.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $500.78	Professional		$32.34	$32.34	$500.78
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 $282.70 / $380.68 / $678.56	Professional		$282.70	$380.68	$678.56