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 $226.53 / $362.10 / $988.59	Professional		$226.53	$362.10	$988.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $349.13 / $435.60 / $487.79	Professional		$349.13	$435.60	$487.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $345.40 / $491.71 / $731.53	Professional		$345.40	$491.71	$731.53
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 $380.39 / $399.52 / $440.83	Professional		$380.39	$399.52	$440.83
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 $322.47 / $447.34 / $714.63	Professional		$322.47	$447.34	$714.63