Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $438.00 / $1,544.00 / $5,389.00	Facility		$438.00	$1,544.00	$5,389.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.39 / $90.20 / $272.77	Professional		$56.39	$90.20	$272.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.00 / $114.48 / $200.65	Professional		$108.00	$114.48	$200.65
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.29 / $140.13 / $225.23	Professional		$100.29	$140.13	$225.23
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 $116.48 / $117.99 / $130.13	Professional		$116.48	$117.99	$130.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $2,500.00 / $2,500.00	Professional		$1,500.00	$2,500.00	$2,500.00
United Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $891.00 / $3,685.00	Facility		$165.00	$891.00	$3,685.00
United Facility/Professional Professional Modifier Low / Median / High Price $80.73 / $116.28 / $206.63	Professional		$80.73	$116.28	$206.63