Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $836.22 / $1,842.00 / $5,091.00	Facility		$836.22	$1,842.00	$5,091.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $696.12 / $836.22 / $1,399.00	Professional		$696.12	$836.22	$1,399.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,295.45 / $8,965.02 / $19,553.84	Facility		$4,295.45	$8,965.02	$19,553.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $985.38 / $1,362.56 / $1,656.11	Professional		$985.38	$1,362.56	$1,656.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $620.00 / $3,072.73 / $3,430.33	Facility		$620.00	$3,072.73	$3,430.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $765.71 / $1,161.23 / $1,671.47	Professional		$765.71	$1,161.23	$1,671.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $893.92 / $1,349.09 / $3,152.93	Professional		$893.92	$1,349.09	$3,152.93
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 $968.41 / $1,025.61 / $1,143.64	Professional		$968.41	$1,025.61	$1,143.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,293.19	Professional		$32.34	$32.34	$1,293.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,095.00 / $2,588.00 / $4,780.00	Facility		$1,095.00	$2,588.00	$4,780.00
United Facility/Professional Professional Modifier Low / Median / High Price $730.39 / $993.43 / $1,663.24	Professional		$730.39	$993.43	$1,663.24