Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $12.88 / $12.88	Facility		$12.88	$12.88	$12.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $16.98 / $33.88	Professional		$12.88	$16.98	$33.88
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $100.00 / $125.89	Professional		$83.18	$100.00	$125.89
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 $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $47.86 / $52.48	Professional		$42.66	$47.86	$52.48