Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.00 / $1,696.00 / $5,389.00	Facility		$630.00	$1,696.00	$5,389.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $452.50 / $614.89 / $1,002.09	Professional		$452.50	$614.89	$1,002.09
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,792.69 / $8,112.72 / $16,245.72	Facility		$3,792.69	$8,112.72	$16,245.72
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 $637.38 / $880.60 / $1,166.67	Professional		$637.38	$880.60	$1,166.67
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $645.77 / $1,000.01 / $3,158.83	Professional		$645.77	$1,000.01	$3,158.83
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 $648.90 / $763.18 / $866.67	Professional		$648.90	$763.18	$866.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,000.01	Professional		$32.34	$32.34	$1,000.01
United Facility/Professional Facility Modifier Low / Median / High Price $578.00 / $2,873.00 / $7,384.00	Facility		$578.00	$2,873.00	$7,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $540.90 / $809.73 / $1,358.41	Professional		$540.90	$809.73	$1,358.41