Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $805.20 / $3,073.00 / $5,549.00	Facility		$805.20	$3,073.00	$5,549.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $805.20 / $805.20 / $805.20	Professional		$805.20	$805.20	$805.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $104.54 / $127.78 / $233.33	Professional		$104.54	$127.78	$233.33
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $144.44 / $146.77 / $159.88	Professional		$144.44	$146.77	$159.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $2,500.00 / $2,500.00	Professional		$40.00	$2,500.00	$2,500.00
United Facility/Professional Facility Modifier Low / Median / High Price $800.00 / $2,800.00 / $7,384.00	Facility		$800.00	$2,800.00	$7,384.00