Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.08 / $735.00 / $4,200.00	Facility		$206.08	$735.00	$4,200.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $145.47 / $249.74 / $309.39	Facility	54	$145.47	$249.74	$309.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.98 / $206.08 / $408.93	Professional		$163.98	$206.08	$408.93
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $122.99 / $145.47 / $268.82	Professional	54	$122.99	$145.47	$268.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $2,079.53 / $4,535.72	Facility		$330.07	$2,079.53	$4,535.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $235.84 / $326.11 / $420.46	Professional		$235.84	$326.11	$420.46
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 $178.03 / $284.24 / $401.53	Professional		$178.03	$284.24	$401.53
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $215.15 / $330.38 / $783.28	Professional		$215.15	$330.38	$783.28
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 $237.43 / $245.43 / $290.50	Professional		$237.43	$245.43	$290.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $328.49	Professional		$32.34	$32.34	$328.49
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 $181.30 / $245.06 / $422.22	Professional		$181.30	$245.06	$422.22