Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $663.63 / $663.63 / $1,050.00	Facility		$663.63	$663.63	$1,050.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $729.99	Professional		$663.63	$663.63	$729.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,520.00 / $3,850.56 / $19,081.43	Facility		$2,520.00	$3,850.56	$19,081.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $814.38 / $814.38 / $814.38	Professional		$814.38	$814.38	$814.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $663.63 / $663.63 / $663.63	Facility		$663.63	$663.63	$663.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $850.00	Professional		$663.63	$663.63	$850.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $564.09 / $822.90 / $1,607.98	Professional		$564.09	$822.90	$1,607.98
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 $862.72 / $862.72 / $862.72	Professional		$862.72	$862.72	$862.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $40.00 / $1,057.47	Professional		$30.00	$40.00	$1,057.47
United Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $727.56	Professional		$663.63	$663.63	$727.56