Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Facility		$25.00	$25.00	$25.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $25.00 / $25.00	Professional		$25.00	$25.00	$25.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.74 / $32.74 / $32.74	Facility		$32.74	$32.74	$32.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.90 / $23.90 / $32.74	Professional		$23.90	$23.90	$32.74
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $69.15 / $93.75 / $102.75	Professional		$69.15	$93.75	$102.75
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 $88.94 / $88.94 / $128.79	Professional		$88.94	$88.94	$128.79