Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $438.00 / $1,169.00 / $4,634.00	Facility		$438.00	$1,169.00	$4,634.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $298.77 / $535.28 / $623.83	Facility	54	$298.77	$535.28	$623.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $334.80 / $398.36 / $713.70	Professional		$334.80	$398.36	$713.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $4,270.68 / $9,314.92	Facility		$330.07	$4,270.68	$9,314.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $478.79 / $662.06 / $811.84	Professional		$478.79	$662.06	$811.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.87 / $280.07 / $480.00	Facility		$250.87	$280.07	$480.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $406.08 / $577.05 / $826.13	Professional		$406.08	$577.05	$826.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $442.29 / $646.14 / $1,378.57	Professional		$442.29	$646.14	$1,378.57
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 $467.45 / $498.94 / $559.99	Professional		$467.45	$498.94	$559.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $633.22	Professional		$32.34	$32.34	$633.22
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 $371.53 / $504.43 / $853.19	Professional		$371.53	$504.43	$853.19