Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $371.22 / $1,129.00 / $4,634.00	Facility		$371.22	$1,129.00	$4,634.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $257.63 / $446.15 / $545.49	Facility	54	$257.63	$446.15	$545.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $291.82 / $343.51 / $631.07	Professional		$291.82	$343.51	$631.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $3,682.68 / $8,032.39	Facility		$330.07	$3,682.68	$8,032.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $413.95 / $572.40 / $752.61	Professional		$413.95	$572.40	$752.61
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 $313.67 / $498.91 / $723.98	Professional		$313.67	$498.91	$723.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $368.12 / $573.65 / $1,231.41	Professional		$368.12	$573.65	$1,231.41
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 $413.89 / $431.20 / $519.58	Professional		$413.89	$431.20	$519.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $587.53	Professional		$32.34	$32.34	$587.53
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 $331.64 / $443.21 / $771.13	Professional		$331.64	$443.21	$771.13