Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3.02 / $3.02 / $3.02	Professional		$3.02	$3.02	$3.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $69.18 / $69.18	Professional		$40.74	$69.18	$69.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $199.53 / $346.74	Professional		$100.00	$199.53	$346.74
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
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $39.81 / $60.26	Professional		$34.67	$39.81	$60.26