Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $65.88 / $65.88	Facility		$65.88	$65.88	$65.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $94.00 / $107.12	Professional		$65.88	$94.00	$107.12
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $36.86 / $52.71 / $120.00	Professional		$36.86	$52.71	$120.00
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 $43.58 / $43.58 / $43.58	Professional		$43.58	$43.58	$43.58
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 $165.00 / $900.00 / $3,686.00	Facility		$165.00	$900.00	$3,686.00
United Facility/Professional Professional Modifier Low / Median / High Price $31.87 / $63.42 / $353.96	Professional		$31.87	$63.42	$353.96