Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $743.75 / $2,989.00 / $5,549.00	Facility		$743.75	$2,989.00	$5,549.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $491.63 / $697.19 / $1,171.70	Professional		$491.63	$697.19	$1,171.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $785.00 / $908.00	Facility		$400.00	$785.00	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $655.36 / $1,098.94 / $1,553.29	Professional		$655.36	$1,098.94	$1,553.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,317.97 / $2,132.73 / $3,654.42	Professional		$1,317.97	$2,132.73	$3,654.42
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,557.60 / $1,584.31 / $1,785.26	Professional		$1,557.60	$1,584.31	$1,785.26
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 $557.00 / $2,873.00 / $6,625.00	Facility		$557.00	$2,873.00	$6,625.00
United Facility/Professional Professional Modifier Low / Median / High Price $640.51 / $1,348.22 / $2,558.02	Professional		$640.51	$1,348.22	$2,558.02