Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Facility		$75.00	$75.00	$75.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.27 / $98.27 / $98.27	Professional		$98.27	$98.27	$98.27
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $262.60 / $359.77 / $402.02	Professional		$262.60	$359.77	$402.02
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