Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,455.84 / $1,455.84 / $1,455.84	Facility		$1,455.84	$1,455.84	$1,455.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,313.57 / $1,551.32 / $2,506.76	Professional		$1,313.57	$1,551.32	$2,506.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,515.49 / $5,947.59 / $25,308.73	Facility		$3,515.49	$5,947.59	$25,308.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,235.48 / $2,235.48 / $2,235.48	Professional		$2,235.48	$2,235.48	$2,235.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,902.78 / $1,902.78 / $3,939.20	Facility		$1,902.78	$1,902.78	$3,939.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,389.03 / $1,902.78 / $3,409.88	Professional		$1,389.03	$1,902.78	$3,409.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,500.21 / $3,693.02 / $4,521.13	Professional		$2,500.21	$3,693.02	$4,521.13
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 $3,823.86 / $3,823.86 / $3,823.86	Professional		$3,823.86	$3,823.86	$3,823.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,792.46 / $2,560.66 / $2,688.69	Professional		$1,792.46	$2,560.66	$2,688.69
United Facility/Professional Professional Modifier Low / Median / High Price $1,324.97 / $1,467.45 / $2,775.07	Professional		$1,324.97	$1,467.45	$2,775.07