Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $333.85 / $1,055.00 / $4,634.00	Facility		$333.85	$1,055.00	$4,634.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $232.23 / $402.80 / $491.86	Facility	54	$232.23	$402.80	$491.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.16 / $311.64 / $609.55	Professional		$260.16	$311.64	$609.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $330.07 / $3,319.55 / $7,240.37	Facility		$330.07	$3,319.55	$7,240.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $373.10 / $515.91 / $676.34	Professional		$373.10	$515.91	$676.34
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 $295.73 / $449.67 / $662.96	Professional		$295.73	$449.67	$662.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $345.40 / $523.05 / $1,127.09	Professional		$345.40	$523.05	$1,127.09
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 $373.22 / $388.56 / $467.00	Professional		$373.22	$388.56	$467.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $528.07	Professional		$32.34	$32.34	$528.07
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 $301.80 / $409.03 / $697.17	Professional		$301.80	$409.03	$697.17