Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Facility		$5.00	$5.00	$5.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Professional		$5.00	$5.00	$5.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.55 / $22.55 / $22.55	Facility		$22.55	$22.55	$22.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $19.17 / $22.55	Professional		$19.17	$19.17	$22.55
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $200.00 / $345.40	Professional		$100.00	$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