Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.02 / $2.02 / $2.02	Facility		$2.02	$2.02	$2.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.02 / $2.02 / $2.02	Professional		$2.02	$2.02	$2.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.87 / $93.87 / $93.87	Professional		$93.87	$93.87	$93.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $161.60 / $221.80 / $256.00	Professional		$161.60	$221.80	$256.00
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