Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $399.69 / $1,169.00 / $4,634.00	Facility		$399.69	$1,169.00	$4,634.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $182.80 / $307.89 / $387.28	Facility	54	$182.80	$307.89	$387.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.12 / $236.03 / $416.76	Professional		$201.12	$236.03	$416.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $2,613.02 / $5,699.32	Facility		$330.07	$2,613.02	$5,699.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.91 / $406.41 / $496.62	Professional		$293.91	$406.41	$496.62
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 $216.30 / $348.55 / $496.20	Professional		$216.30	$348.55	$496.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $260.24 / $394.14 / $1,402.58	Professional		$260.24	$394.14	$1,402.58
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 $292.79 / $305.64 / $343.27	Professional		$292.79	$305.64	$343.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $388.15	Professional		$32.34	$32.34	$388.15
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 $212.11 / $285.99 / $495.27	Professional		$212.11	$285.99	$495.27