Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $956.93 / $1,842.00 / $5,430.00	Facility		$956.93	$1,842.00	$5,430.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $714.92 / $956.93 / $1,752.90	Professional		$714.92	$956.93	$1,752.90
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,840.04 / $12,492.08 / $25,015.39	Facility		$5,840.04	$12,492.08	$25,015.39
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 $866.34 / $1,328.57 / $1,819.11	Professional		$866.34	$1,328.57	$1,819.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,051.33 / $1,563.61 / $4,864.31	Professional		$1,051.33	$1,563.61	$4,864.31
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 $1,094.94 / $1,193.69 / $1,328.56	Professional		$1,094.94	$1,193.69	$1,328.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,502.30	Professional		$32.34	$32.34	$1,502.30
United Facility/Professional Facility Modifier Low / Median / High Price $2,537.00 / $6,885.00 / $14,716.00	Facility		$2,537.00	$6,885.00	$14,716.00
United Facility/Professional Professional Modifier Low / Median / High Price $821.61 / $1,117.67 / $2,089.19	Professional		$821.61	$1,117.67	$2,089.19