Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $15.00 / $15.00	Professional		$15.00	$15.00	$15.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $64.00 / $64.00	Facility		$64.00	$64.00	$64.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.68 / $1.68 / $1.68	Professional		$1.68	$1.68	$1.68
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.00 / $345.40	Professional		$100.00	$125.00	$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 $30.00 / $30.00 / $2,500.00	Professional		$30.00	$30.00	$2,500.00