Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $676.00 / $2,265.00 / $5,393.00	Facility		$676.00	$2,265.00	$5,393.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $280.66 / $434.62 / $696.13	Professional		$280.66	$434.62	$696.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.00 / $315.00 / $603.49	Professional		$252.00	$315.00	$603.49
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $239.63 / $336.17 / $559.59	Professional		$239.63	$336.17	$559.59
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 $271.64 / $281.92 / $315.82	Professional		$271.64	$281.92	$315.82
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 / $891.00 / $3,685.00	Facility		$165.00	$891.00	$3,685.00
United Facility/Professional Professional Modifier Low / Median / High Price $529.42 / $782.39 / $1,260.46	Professional		$529.42	$782.39	$1,260.46