Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,548.82	Facility		$1,548.82	$1,548.82	$1,548.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $3,801.89	Professional		$1,548.82	$1,548.82	$3,801.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,630.27 / $3,801.89 / $4,786.30	Professional		$2,630.27	$3,801.89	$4,786.30
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $17,378.01 / $21,379.62 / $25,118.86	Professional		$17,378.01	$21,379.62	$25,118.86
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