Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $3,548.13	Facility		$1,737.80	$1,737.80	$3,548.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,737.80 / $3,235.94	Professional		$1,258.93	$1,737.80	$3,235.94
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,168.69 / $6,760.83 / $23,988.33	Facility		$4,168.69	$6,760.83	$23,988.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Professional		$2,630.27	$2,630.27	$2,630.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $3,548.13	Facility		$1,819.70	$1,819.70	$3,548.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $3,548.13	Professional		$1,318.26	$1,318.26	$3,548.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,951.21 / $3,801.89 / $4,786.30	Professional		$2,951.21	$3,801.89	$4,786.30
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 $4,570.88 / $4,570.88 / $4,570.88	Professional		$4,570.88	$4,570.88	$4,570.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $2,630.27	Professional		$1,819.70	$1,819.70	$2,630.27
United Facility/Professional Facility Modifier Low / Median / High Price $1,949.84 / $2,818.38 / $4,786.30	Facility		$1,949.84	$2,818.38	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,737.80 / $2,630.27	Professional		$1,288.25	$1,737.80	$2,630.27