Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,159.00 / $2,095.62 / $5,430.00	Facility		$1,159.00	$2,095.62	$5,430.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,014.38 / $1,180.31 / $2,095.62	Professional		$1,014.38	$1,180.31	$2,095.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,935.08 / $12,937.52 / $25,907.38	Facility		$5,935.08	$12,937.52	$25,907.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,359.08 / $1,606.87 / $2,032.32	Professional		$1,359.08	$1,606.87	$2,032.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $785.00 / $1,246.15	Facility		$400.00	$785.00	$1,246.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,004.02 / $1,580.21 / $2,380.85	Professional		$1,004.02	$1,580.21	$2,380.85
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,152.93 / $1,828.64 / $4,681.46	Professional		$1,152.93	$1,828.64	$4,681.46
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 $1,249.56 / $1,421.49 / $1,598.14	Professional		$1,249.56	$1,421.49	$1,598.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,807.13	Professional		$32.34	$32.34	$1,807.13
United Facility/Professional Facility Modifier Low / Median / High Price $557.00 / $2,873.00 / $6,625.00	Facility		$557.00	$2,873.00	$6,625.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,052.72 / $1,444.04 / $2,530.11	Professional		$1,052.72	$1,444.04	$2,530.11