Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $144.54 / $144.54	Facility		$81.28	$144.54	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $83.18	Professional		$57.54	$67.61	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $117.49	Professional		$66.07	$81.28	$117.49
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 $91.20 / $100.00 / $107.15	Professional		$91.20	$100.00	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $109.65	Professional		$32.36	$33.11	$109.65
United Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $93.33 / $141.25	Professional		$70.79	$93.33	$141.25