Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.67 / $54.67 / $54.67	Facility		$54.67	$54.67	$54.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.52 / $54.67 / $90.53	Professional		$44.52	$54.67	$90.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.13 / $93.13 / $93.13	Facility		$93.13	$93.13	$93.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.13 / $93.13 / $93.13	Professional		$93.13	$93.13	$93.13
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 $91.30 / $91.30 / $103.17	Professional		$91.30	$91.30	$103.17