Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $438.00 / $1,609.00 / $5,389.00	Facility		$438.00	$1,609.00	$5,389.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $157.62 / $177.22 / $274.75	Professional		$157.62	$177.22	$274.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.14 / $278.16 / $374.46	Professional		$196.14	$278.16	$374.46
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $345.40 / $724.39 / $942.18	Professional		$345.40	$724.39	$942.18
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 / $900.00 / $3,686.00	Facility		$165.00	$900.00	$3,686.00
United Facility/Professional Professional Modifier Low / Median / High Price $192.13 / $322.04 / $586.15	Professional		$192.13	$322.04	$586.15