Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $755.00 / $2,989.00 / $5,580.00	Facility		$755.00	$2,989.00	$5,580.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.73 / $288.18 / $364.26	Professional		$196.73	$288.18	$364.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $423.47 / $423.47 / $423.47	Professional		$423.47	$423.47	$423.47
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $345.40 / $684.46	Professional		$100.00	$345.40	$684.46
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 $341.77 / $456.56 / $731.03	Professional		$341.77	$456.56	$731.03