Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $762.00 / $1,842.00 / $5,430.00	Facility		$762.00	$1,842.00	$5,430.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $824.00 / $2,416.39 / $3,546.64	Professional		$824.00	$2,416.39	$3,546.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,092.93 / $1,367.56 / $1,682.17	Facility		$1,092.93	$1,367.56	$1,682.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $908.00 / $2,769.00	Facility		$400.00	$908.00	$2,769.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $313.24 / $313.24 / $313.24	Professional		$313.24	$313.24	$313.24
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $200.00 / $345.40	Professional		$100.00	$200.00	$345.40
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $2,500.00 / $2,500.00	Professional		$1,500.00	$2,500.00	$2,500.00
United Facility/Professional Facility Modifier Low / Median / High Price $815.00 / $2,588.00 / $4,780.00	Facility		$815.00	$2,588.00	$4,780.00