Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,042.10 / $5,405.00 / $9,691.00	Facility		$1,042.10	$5,405.00	$9,691.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,042.10 / $1,567.65 / $2,404.48	Professional		$1,042.10	$1,567.65	$2,404.48
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $200.00 / $345.40	Professional		$100.00	$200.00	$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 $578.00 / $2,873.00 / $7,384.00	Facility		$578.00	$2,873.00	$7,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,998.37 / $2,986.16 / $4,981.53	Professional		$1,998.37	$2,986.16	$4,981.53