Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,726.10 / $3,692.14 / $3,692.14	Facility		$2,726.10	$3,692.14	$3,692.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,692.14 / $3,692.14 / $3,839.83	Professional		$3,692.14	$3,692.14	$3,839.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $3,315.87 / $3,315.87 / $3,315.87	Professional		$3,315.87	$3,315.87	$3,315.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,692.14 / $3,692.14 / $3,692.14	Facility		$3,692.14	$3,692.14	$3,692.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,692.14 / $3,692.14 / $3,692.14	Professional		$3,692.14	$3,692.14	$3,692.14
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $2,763.60 / $3,692.14 / $5,538.21	Professional		$2,763.60	$3,692.14	$5,538.21
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 $4,799.78 / $4,799.78 / $4,799.78	Professional		$4,799.78	$4,799.78	$4,799.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $40.00 / $4,305.66	Professional		$30.00	$40.00	$4,305.66
United Facility/Professional Professional Modifier Low / Median / High Price $3,692.14 / $3,692.14 / $3,917.36	Professional		$3,692.14	$3,692.14	$3,917.36