Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $380.50 / $2,989.00 / $5,549.00	Facility		$380.50	$2,989.00	$5,549.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $334.86 / $380.50 / $747.31	Professional		$334.86	$380.50	$747.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $587.00 / $908.00	Facility		$400.00	$587.00	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $357.66 / $533.01 / $707.70	Professional		$357.66	$533.01	$707.70
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,117.10 / $1,726.44 / $4,932.31	Professional		$1,117.10	$1,726.44	$4,932.31
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 $1,315.13 / $1,320.22 / $1,400.22	Professional		$1,315.13	$1,320.22	$1,400.22
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 $345.27 / $501.55 / $790.95	Professional		$345.27	$501.55	$790.95