Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,070.95 / $1,070.95 / $1,070.95	Facility		$1,070.95	$1,070.95	$1,070.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $943.12 / $1,070.95 / $1,775.29	Professional		$943.12	$1,070.95	$1,775.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,585.34 / $4,373.93 / $18,617.52	Facility		$2,585.34	$4,373.93	$18,617.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,644.47 / $1,644.47 / $1,644.47	Professional		$1,644.47	$1,644.47	$1,644.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,207.83 / $1,207.83 / $2,368.44	Facility		$1,207.83	$1,207.83	$2,368.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $881.72 / $1,207.83 / $2,508.38	Professional		$881.72	$1,207.83	$2,508.38
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,839.20 / $2,488.44 / $3,037.74	Professional		$1,839.20	$2,488.44	$3,037.74
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 $2,812.90 / $2,812.90 / $2,812.90	Professional		$2,812.90	$2,812.90	$2,812.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,318.56 / $1,883.67 / $1,977.85	Professional		$1,318.56	$1,883.67	$1,977.85
United Facility/Professional Facility Modifier Low / Median / High Price $1,055.55 / $1,055.55 / $1,055.55	Facility		$1,055.55	$1,055.55	$1,055.55
United Facility/Professional Professional Modifier Low / Median / High Price $862.31 / $1,079.48 / $1,853.10	Professional		$862.31	$1,079.48	$1,853.10