Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.00 / $2,265.00 / $5,405.00	Facility		$630.00	$2,265.00	$5,405.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.34 / $158.81 / $273.13	Professional		$104.34	$158.81	$273.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.99 / $230.03 / $305.08	Professional		$191.99	$230.03	$305.08
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $149.27 / $214.60 / $345.40	Professional		$149.27	$214.60	$345.40
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 $194.05 / $194.57 / $213.90	Professional		$194.05	$194.57	$213.90
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 $150.00 / $963.00 / $3,686.00	Facility		$150.00	$963.00	$3,686.00
United Facility/Professional Professional Modifier Low / Median / High Price $156.47 / $230.58 / $402.37	Professional		$156.47	$230.58	$402.37