Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $494.43 / $802.79 / $1,739.55	Facility		$494.43	$802.79	$1,739.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $494.43 / $495.55 / $642.76	Professional		$494.43	$495.55	$642.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,283.80 / $2,001.68 / $9,919.32	Facility		$1,283.80	$2,001.68	$9,919.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $495.55 / $495.55 / $495.55	Facility		$495.55	$495.55	$495.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $495.55	Professional		$495.55	$495.55	$495.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $421.22 / $560.99 / $1,429.50	Professional		$421.22	$560.99	$1,429.50
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 $644.22 / $644.22 / $644.22	Professional		$644.22	$644.22	$644.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $495.55 / $495.55 / $510.42	Professional		$495.55	$495.55	$510.42