Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $963.48 / $963.48 / $963.48	Facility		$963.48	$963.48	$963.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $783.36 / $963.48 / $1,499.64	Professional		$783.36	$963.48	$1,499.64
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,240.31 / $3,790.21 / $16,129.11	Facility		$2,240.31	$3,790.21	$16,129.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,212.63 / $1,212.63 / $2,071.21	Facility		$1,212.63	$1,212.63	$2,071.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $885.22 / $1,212.63 / $2,173.13	Professional		$885.22	$1,212.63	$2,173.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,556.52 / $2,008.61 / $2,454.77	Professional		$1,556.52	$2,008.61	$2,454.77
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 $2,436.92 / $2,436.92 / $2,436.92	Professional		$2,436.92	$2,436.92	$2,436.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,058.24 / $1,511.78 / $1,587.36	Professional		$1,058.24	$1,511.78	$1,587.36
United Facility/Professional Professional Modifier Low / Median / High Price $713.69 / $935.20 / $1,605.42	Professional		$713.69	$935.20	$1,605.42