Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $812.83 / $1,288.25	Facility		$489.78	$812.83	$1,288.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $691.83	Professional		$489.78	$489.78	$691.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,995.26 / $10,000.00	Facility		$1,318.26	$1,995.26	$10,000.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Facility		$489.78	$489.78	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Professional		$489.78	$489.78	$489.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $645.65 / $1,584.89	Professional		$346.74	$645.65	$1,584.89
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 $645.65 / $645.65 / $645.65	Professional		$645.65	$645.65	$645.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $501.19 / $812.83	Facility		$489.78	$501.19	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $549.54 / $549.54	Professional		$489.78	$549.54	$549.54