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 $56.77 / $85.61 / $111.97	Professional		$56.77	$85.61	$111.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.93 / $120.05 / $141.56	Professional		$102.93	$120.05	$141.56
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $106.30 / $144.96 / $239.81	Professional		$106.30	$144.96	$239.81
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 $122.45 / $125.63 / $139.22	Professional		$122.45	$125.63	$139.22
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 / $3,592.00	Facility		$165.00	$891.00	$3,592.00
United Facility/Professional Professional Modifier Low / Median / High Price $88.34 / $127.16 / $201.89	Professional		$88.34	$127.16	$201.89