Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.56 / $211.67 / $633.19	Facility		$136.56	$211.67	$633.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.96 / $92.96 / $154.62	Professional		$92.96	$92.96	$154.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $329.27 / $345.40	Professional		$120.00	$329.27	$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 Professional Modifier Low / Median / High Price $170.34 / $240.39 / $437.58	Professional		$170.34	$240.39	$437.58