Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $628.00 / $628.00 / $628.00	Professional		$628.00	$628.00	$628.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2.59 / $2.59 / $2.59	Professional		$2.59	$2.59	$2.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $336.43 / $481.70 / $568.86	Professional		$336.43	$481.70	$568.86
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 $30.00 / $30.00 / $2,500.00	Professional		$30.00	$30.00	$2,500.00