Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $801.62 / $1,696.00 / $5,389.00	Facility		$801.62	$1,696.00	$5,389.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.11 / $801.62 / $1,333.60	Professional		$630.11	$801.62	$1,333.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,372.92 / $9,353.84 / $18,731.06	Facility		$4,372.92	$9,353.84	$18,731.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $831.36 / $1,198.53 / $1,289.54	Professional		$831.36	$1,198.53	$1,289.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $875.00 / $908.00	Facility		$875.00	$875.00	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $651.83 / $992.17 / $1,463.51	Professional		$651.83	$992.17	$1,463.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $733.07 / $1,126.91 / $2,989.94	Professional		$733.07	$1,126.91	$2,989.94
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 $837.14 / $866.36 / $955.42	Professional		$837.14	$866.36	$955.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,102.41	Professional		$32.34	$32.34	$1,102.41
United Facility/Professional Facility Modifier Low / Median / High Price $749.00 / $2,622.00 / $5,026.00	Facility		$749.00	$2,622.00	$5,026.00
United Facility/Professional Professional Modifier Low / Median / High Price $698.71 / $959.85 / $1,643.12	Professional		$698.71	$959.85	$1,643.12