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 $161.84 / $237.25 / $295.66	Professional		$161.84	$237.25	$295.66
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $150.00 / $345.40	Professional		$100.00	$150.00	$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 $30.00 / $30.00 / $2,500.00	Professional		$30.00	$30.00	$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 $273.35 / $374.87 / $606.12	Professional		$273.35	$374.87	$606.12