Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,696.32 / $1,696.32 / $1,696.32	Facility		$1,696.32	$1,696.32	$1,696.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,493.85 / $1,696.32 / $2,811.96	Professional		$1,493.85	$1,696.32	$2,811.96
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,095.84 / $6,929.44 / $29,489.23	Facility		$4,095.84	$6,929.44	$29,489.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,604.75 / $2,604.75 / $2,604.75	Professional		$2,604.75	$2,604.75	$2,604.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,217.07 / $2,217.07 / $3,751.50	Facility		$2,217.07	$2,217.07	$3,751.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,618.46 / $2,217.07 / $3,973.13	Professional		$1,618.46	$2,217.07	$3,973.13
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,913.21 / $3,989.59 / $4,870.26	Professional		$2,913.21	$3,989.59	$4,870.26
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 $4,455.49 / $4,455.49 / $4,455.49	Professional		$4,455.49	$4,455.49	$4,455.49
United Facility/Professional Facility Modifier Low / Median / High Price $2,018.42 / $2,133.69 / $3,427.30	Facility		$2,018.42	$2,133.69	$3,427.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,279.26 / $1,709.84 / $3,002.24	Professional		$1,279.26	$1,709.84	$3,002.24