Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,637.19 / $1,637.19 / $1,637.19	Facility		$1,637.19	$1,637.19	$1,637.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,230.08 / $1,641.73 / $2,422.57	Professional		$1,230.08	$1,641.73	$2,422.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,952.74 / $6,687.34 / $28,461.39	Facility		$3,952.74	$6,687.34	$28,461.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,513.96 / $2,513.96 / $2,513.96	Professional		$2,513.96	$2,513.96	$2,513.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,084.13 / $2,084.13 / $3,054.39	Facility		$2,084.13	$2,084.13	$3,054.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,521.41 / $2,084.13 / $3,834.75	Professional		$1,521.41	$2,084.13	$3,834.75
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,759.00 / $3,351.10 / $4,290.39	Professional		$2,759.00	$3,351.10	$4,290.39
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 $4,300.18 / $4,300.18 / $4,300.18	Professional		$4,300.18	$4,300.18	$4,300.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,867.36 / $2,667.66 / $2,801.04	Professional		$1,867.36	$2,667.66	$2,801.04
United Facility/Professional Facility Modifier Low / Median / High Price $1,815.91 / $1,919.63 / $3,307.84	Facility		$1,815.91	$1,919.63	$3,307.84
United Facility/Professional Professional Modifier Low / Median / High Price $1,228.81 / $1,650.25 / $2,897.61	Professional		$1,228.81	$1,650.25	$2,897.61