Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.79 / $47.79 / $197.12	Facility		$47.79	$47.79	$197.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.79 / $76.43 / $89.86	Professional		$47.79	$76.43	$89.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.70 / $94.70 / $94.70	Facility		$94.70	$94.70	$94.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.90 / $97.67 / $396.01	Professional		$42.90	$97.67	$396.01
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $167.47 / $345.40	Professional		$120.00	$167.47	$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 $785.00 / $2,873.00 / $6,625.00	Facility		$785.00	$2,873.00	$6,625.00
United Facility/Professional Professional Modifier Low / Median / High Price $78.28 / $105.73 / $165.69	Professional		$78.28	$105.73	$165.69