Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $826.00 / $1,972.00 / $5,389.00	Facility		$826.00	$1,972.00	$5,389.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $892.83 / $1,079.16 / $1,968.81	Professional		$892.83	$1,079.16	$1,968.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,938.16 / $11,569.57 / $25,234.70	Facility		$3,938.16	$11,569.57	$25,234.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,290.15 / $1,783.98 / $2,174.86	Professional		$1,290.15	$1,783.98	$2,174.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $2,338.66 / $2,610.83	Facility		$875.00	$2,338.66	$2,610.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,062.51 / $1,554.10 / $2,277.15	Professional		$1,062.51	$1,554.10	$2,277.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,209.40 / $1,813.12 / $4,742.97	Professional		$1,209.40	$1,813.12	$4,742.97
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 $1,244.39 / $1,346.89 / $1,497.35	Professional		$1,244.39	$1,346.89	$1,497.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,693.16	Professional		$32.34	$32.34	$1,693.16
United Facility/Professional Facility Modifier Low / Median / High Price $1,499.00 / $3,671.00 / $6,514.00	Facility		$1,499.00	$3,671.00	$6,514.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,002.33 / $1,355.54 / $2,338.53	Professional		$1,002.33	$1,355.54	$2,338.53