Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,664.60 / $3,248.00 / $5,298.30	Facility		$1,664.60	$3,248.00	$5,298.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,563.10 / $1,725.50 / $2,436.00	Professional		$1,563.10	$1,725.50	$2,436.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $3,491.60 / $26,854.05	Facility		$19.95	$3,491.60	$26,854.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3.50 / $1,400.70 / $1,563.10	Professional		$3.50	$1,400.70	$1,563.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,796.02 / $4,961.83 / $9,345.41	Facility		$2,796.02	$4,961.83	$9,345.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,038.38 / $2,472.58 / $3,426.65	Professional		$1,038.38	$2,472.58	$3,426.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,070.60 / $3,192.18 / $4,770.28	Professional		$2,070.60	$3,192.18	$4,770.28
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 $2,639.00 / $2,639.00 / $2,639.00	Professional		$2,639.00	$2,639.00	$2,639.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $2,760.80 / $2,760.80 / $3,045.00	Professional		$2,760.80	$2,760.80	$3,045.00
United Facility/Professional Professional Modifier Low / Median / High Price $852.60 / $1,218.00 / $2,030.00	Professional		$852.60	$1,218.00	$2,030.00