Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $802.28 / $802.28 / $802.28	Facility		$802.28	$802.28	$802.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $519.91 / $802.28 / $1,157.38	Professional		$519.91	$802.28	$1,157.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,513.06 / $4,294.39 / $13,430.44	Facility		$2,513.06	$4,294.39	$13,430.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $945.08 / $1,186.29 / $1,186.29	Professional		$945.08	$1,186.29	$1,186.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,014.49 / $1,014.49 / $1,570.79	Facility		$1,014.49	$1,014.49	$1,570.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $740.58 / $1,014.49 / $1,809.75	Professional		$740.58	$1,014.49	$1,809.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,221.24 / $1,560.91 / $1,898.09	Professional		$1,221.24	$1,560.91	$1,898.09
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 $2,029.18 / $2,029.18 / $2,029.18	Professional		$2,029.18	$2,029.18	$2,029.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $760.07 / $1,085.82 / $1,140.11	Professional		$760.07	$1,085.82	$1,140.11
United Facility/Professional Professional Modifier Low / Median / High Price $525.22 / $771.77 / $1,378.90	Professional		$525.22	$771.77	$1,378.90