Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,083.96 / $1,083.96 / $1,083.96	Facility		$1,083.96	$1,083.96	$1,083.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $954.62 / $1,083.96 / $1,796.94	Professional		$954.62	$1,083.96	$1,796.94
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,617.14 / $4,427.74 / $18,843.87	Facility		$2,617.14	$4,427.74	$18,843.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,664.45 / $1,664.45 / $1,664.45	Professional		$1,664.45	$1,664.45	$1,664.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,222.54 / $1,222.54 / $2,397.29	Facility		$1,222.54	$1,222.54	$2,397.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $892.45 / $892.45 / $2,691.47	Professional		$892.45	$892.45	$2,691.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,861.56 / $2,518.58 / $3,066.10	Professional		$1,861.56	$2,518.58	$3,066.10
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 $2,847.09 / $2,847.09 / $2,847.09	Professional		$2,847.09	$2,847.09	$2,847.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,334.59 / $1,906.56 / $2,001.88	Professional		$1,334.59	$1,906.56	$2,001.88
United Facility/Professional Facility Modifier Low / Median / High Price $2,190.07 / $3,130.40 / $5,817.33	Facility		$2,190.07	$3,130.40	$5,817.33
United Facility/Professional Professional Modifier Low / Median / High Price $817.49 / $1,092.59 / $1,934.70	Professional		$817.49	$1,092.59	$1,934.70