Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $63.10 / $123.03	Professional		$51.29	$63.10	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $85.11 / $173.78	Professional		$56.23	$85.11	$173.78
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $91.20 / $281.84	Professional		$57.54	$91.20	$281.84
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $69.18 / $74.13	Professional		$66.07	$69.18	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $91.20 / $134.90	Professional		$63.10	$91.20	$134.90