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 Professional Modifier Low / Median / High Price $323.30 / $376.36 / $688.78	Professional		$323.30	$376.36	$688.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $4,000.53 / $8,725.68	Facility		$330.07	$4,000.53	$8,725.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $451.79 / $624.72 / $826.20	Professional		$451.79	$624.72	$826.20
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 $341.35 / $544.51 / $781.88	Professional		$341.35	$544.51	$781.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $405.44 / $632.50 / $1,479.74	Professional		$405.44	$632.50	$1,479.74
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 $448.05 / $469.86 / $571.23	Professional		$448.05	$469.86	$571.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $651.11	Professional		$32.34	$32.34	$651.11
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 $345.65 / $474.63 / $848.81	Professional		$345.65	$474.63	$848.81