Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.71 / $1,363.00 / $5,389.00	Facility		$202.71	$1,363.00	$5,389.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.99 / $131.82 / $230.87	Professional		$107.99	$131.82	$230.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,099.85 / $2,136.02 / $2,990.43	Facility		$1,099.85	$2,136.02	$2,990.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.31 / $141.31 / $180.04	Professional		$141.31	$141.31	$180.04
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $125.91 / $198.82 / $655.57	Professional		$125.91	$198.82	$655.57
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 $148.80 / $152.74 / $164.01	Professional		$148.80	$152.74	$164.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $2,622.00 / $5,026.00	Facility		$1,183.00	$2,622.00	$5,026.00
United Facility/Professional Professional Modifier Low / Median / High Price $114.49 / $167.51 / $266.50	Professional		$114.49	$167.51	$266.50