Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.48 / $12.48 / $130.97	Facility		$12.48	$12.48	$130.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.48 / $12.48 / $13.26	Professional		$12.48	$12.48	$13.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.26 / $13.26 / $13.26	Facility		$13.26	$13.26	$13.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.26 / $13.26 / $13.26	Professional		$13.26	$13.26	$13.26
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $200.00 / $345.40	Professional		$120.00	$200.00	$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 $1,500.00 / $2,500.00 / $2,500.00	Professional		$1,500.00	$2,500.00	$2,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $13.00 / $14.25	Professional		$13.00	$13.00	$14.25