Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $3,235.94 / $9,772.37	Facility		$630.96	$3,235.94	$9,772.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $97.72 / $112.20	Professional		$58.88	$97.72	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $218.78	Professional		$120.23	$120.23	$218.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $190.55 / $346.74	Professional		$112.20	$190.55	$346.74
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,513.56 / $2,511.89	Professional		$1,513.56	$1,513.56	$2,511.89
United Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $851.14 / $2,630.27	Facility		$151.36	$851.14	$2,630.27
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $194.98	Professional		$89.13	$120.23	$194.98