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 $163.19 / $248.49 / $472.23	Professional		$163.19	$248.49	$472.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $528.45 / $528.45 / $528.45	Professional		$528.45	$528.45	$528.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $150.00 / $345.40	Professional		$100.00	$150.00	$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
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 $158.00 / $916.00 / $3,592.00	Facility		$158.00	$916.00	$3,592.00
United Facility/Professional Professional Modifier Low / Median / High Price $379.94 / $532.49 / $885.65	Professional		$379.94	$532.49	$885.65