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 Professional Modifier Low / Median / High Price $31.24 / $31.24 / $31.24	Professional		$31.24	$31.24	$31.24
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 $30.00 / $40.00 / $2,500.00	Professional		$30.00	$40.00	$2,500.00