Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $128.82 / $128.82	Professional		$117.49	$128.82	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $95.50 / $131.83	Professional		$16.60	$95.50	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $13.18 / $13.18	Professional		$13.18	$13.18	$13.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $199.53 / $245.47	Professional		$165.96	$199.53	$245.47
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 / $2,511.89	Professional		$30.20	$30.20	$2,511.89