Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.41 / $55.41 / $1,386.49	Facility		$55.41	$55.41	$1,386.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.41 / $86.84 / $112.99	Professional		$55.41	$86.84	$112.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.27 / $114.35 / $353.50	Professional		$27.27	$114.35	$353.50
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $44.31 / $75.63 / $121.82	Professional		$44.31	$75.63	$121.82
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 $29.76 / $65.98 / $72.83	Professional		$29.76	$65.98	$72.83
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 Professional Modifier Low / Median / High Price $53.28 / $77.33 / $139.72	Professional		$53.28	$77.33	$139.72