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 $208.43 / $305.61 / $365.69	Professional		$208.43	$305.61	$365.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $704.98 / $704.98 / $704.98	Professional		$704.98	$704.98	$704.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $200.00 / $495.28	Professional		$100.00	$200.00	$495.28
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 $150.00 / $963.00 / $3,686.00	Facility		$150.00	$963.00	$3,686.00
United Facility/Professional Professional Modifier Low / Median / High Price $325.89 / $433.43 / $700.51	Professional		$325.89	$433.43	$700.51