Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $893.75 / $2,758.00 / $5,580.00	Facility		$893.75	$2,758.00	$5,580.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $738.38 / $893.75 / $1,623.27	Professional		$738.38	$893.75	$1,623.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,331.47 / $9,581.75 / $20,899.00	Facility		$4,331.47	$9,581.75	$20,899.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $3,072.73 / $3,430.33	Facility		$875.00	$3,072.73	$3,430.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $899.72 / $1,285.31 / $1,845.28	Professional		$899.72	$1,285.31	$1,845.28
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,007.34 / $1,465.25 / $3,602.05	Professional		$1,007.34	$1,465.25	$3,602.05
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 $1,029.20 / $1,113.93 / $1,239.55	Professional		$1,029.20	$1,113.93	$1,239.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,401.65	Professional		$32.34	$32.34	$1,401.65
United Facility/Professional Facility Modifier Low / Median / High Price $2,100.00 / $5,820.00 / $12,241.00	Facility		$2,100.00	$5,820.00	$12,241.00
United Facility/Professional Professional Modifier Low / Median / High Price $823.38 / $1,115.83 / $1,934.95	Professional		$823.38	$1,115.83	$1,934.95