Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.19 / $1,289.00 / $5,389.00	Facility		$160.19	$1,289.00	$5,389.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $30.03 / $80.09 / $80.09	Facility	52	$30.03	$80.09	$80.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.66 / $63.67 / $147.74	Professional		$52.66	$63.67	$147.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $589.57 / $1,152.33 / $1,624.10	Facility		$589.57	$1,152.33	$1,624.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.01 / $103.68 / $121.57	Professional		$80.01	$103.68	$121.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $463.00 / $929.98 / $1,038.21	Facility		$463.00	$929.98	$1,038.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.92 / $106.98 / $180.25	Professional		$69.92	$106.98	$180.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $76.28 / $117.33 / $1,266.67	Professional		$76.28	$117.33	$1,266.67
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 $76.56 / $82.64 / $89.73	Professional		$76.56	$82.64	$89.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $101.46	Professional		$32.34	$32.34	$101.46
United Facility/Professional Facility Modifier Low / Median / High Price $807.00 / $1,753.00 / $4,256.00	Facility		$807.00	$1,753.00	$4,256.00
United Facility/Professional Professional Modifier Low / Median / High Price $61.37 / $108.62 / $191.38	Professional		$61.37	$108.62	$191.38