Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $314.77 / $849.00 / $4,634.00	Facility		$314.77	$849.00	$4,634.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $220.08 / $384.18 / $465.54	Facility	54	$220.08	$384.18	$465.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $262.52 / $314.77 / $558.16	Professional		$262.52	$314.77	$558.16
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $3,145.91 / $6,861.63	Facility		$330.07	$3,145.91	$6,861.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.58 / $490.30 / $638.79	Professional		$354.58	$490.30	$638.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.87 / $250.87 / $280.07	Facility		$250.87	$250.87	$280.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $273.45 / $427.35 / $625.85	Professional		$273.45	$427.35	$625.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $334.75 / $497.46 / $1,055.11	Professional		$334.75	$497.46	$1,055.11
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 $353.74 / $369.54 / $440.78	Professional		$353.74	$369.54	$440.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $498.42	Professional		$32.34	$32.34	$498.42
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 $272.23 / $395.64 / $685.00	Professional		$272.23	$395.64	$685.00