Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Facility		$30.00	$30.00	$30.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.32 / $19.32 / $19.32	Professional		$19.32	$19.32	$19.32
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $29.96 / $40.61 / $46.57	Professional		$29.96	$40.61	$46.57
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 / $1,500.00	Professional		$30.00	$30.00	$1,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $188.65 / $188.65 / $188.65	Professional		$188.65	$188.65	$188.65