Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $923.00 / $3,221.00 / $10,073.00	Facility		$923.00	$3,221.00	$10,073.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,017.00 / $5,389.00 / $11,617.00	Professional		$1,017.00	$5,389.00	$11,617.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $101.17 / $149.41 / $300.39	Facility		$101.17	$149.41	$300.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.43 / $127.93 / $136.10	Professional		$71.43	$127.93	$136.10
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 $86.30 / $96.62 / $2,500.00	Professional		$86.30	$96.62	$2,500.00
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $900.00 / $3,686.00	Facility		$165.00	$900.00	$3,686.00
United Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $110.49 / $160.85	Professional		$75.02	$110.49	$160.85