Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Facility		$42.66	$42.66	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $67.61 / $104.71	Professional		$30.20	$67.61	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $27.54 / $128.82	Professional		$21.88	$27.54	$128.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $346.74 / $346.74	Professional		$100.00	$346.74	$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 $1,513.56 / $2,511.89 / $2,511.89	Professional		$1,513.56	$2,511.89	$2,511.89
United Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Facility		$56.23	$56.23	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $120.23 / $257.04	Professional		$72.44	$120.23	$257.04