Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $439.86 / $1,008.22 / $5,389.00	Facility		$439.86	$1,008.22	$5,389.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $229.64 / $399.89 / $486.77	Facility	54	$229.64	$399.89	$486.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.07 / $312.58 / $587.59	Professional		$266.07	$312.58	$587.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $3,282.50 / $7,159.55	Facility		$330.07	$3,282.50	$7,159.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $368.66 / $509.76 / $683.09	Professional		$368.66	$509.76	$683.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.87 / $280.07 / $643.00	Facility		$250.87	$280.07	$643.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $307.33 / $453.60 / $657.86	Professional		$307.33	$453.60	$657.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $354.80 / $518.78 / $1,131.66	Professional		$354.80	$518.78	$1,131.66
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 $368.37 / $383.92 / $471.74	Professional		$368.37	$383.92	$471.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $533.42	Professional		$32.34	$32.34	$533.42
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 $290.54 / $387.45 / $697.01	Professional		$290.54	$387.45	$697.01