Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.38 / $120.22 / $183.78	Professional		$104.38	$120.22	$183.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.92 / $108.92 / $108.92	Professional		$108.92	$108.92	$108.92
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $107.94 / $151.37 / $541.79	Professional		$107.94	$151.37	$541.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $140.56 / $147.03 / $157.86	Professional		$140.56	$147.03	$157.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $178.50	Professional		$32.34	$32.34	$178.50
United Facility/Professional Professional Modifier Low / Median / High Price $119.64 / $169.42 / $286.55	Professional		$119.64	$169.42	$286.55