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 $46.78 / $72.39 / $96.21	Professional		$46.78	$72.39	$96.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.15 / $85.15 / $101.40	Professional		$85.15	$85.15	$101.40
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $164.11 / $345.40	Professional		$120.00	$164.11	$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 $165.00 / $891.00 / $3,685.00	Facility		$165.00	$891.00	$3,685.00
United Facility/Professional Professional Modifier Low / Median / High Price $74.91 / $113.65 / $175.73	Professional		$74.91	$113.65	$175.73