Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $199.53 / $346.74	Professional		$100.00	$199.53	$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 $30.20 / $30.20 / $39.81	Professional		$30.20	$30.20	$39.81