Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $41.01 / $41.01	Facility		$41.01	$41.01	$41.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $105.00 / $118.45	Professional		$40.00	$105.00	$118.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.82 / $51.82 / $51.82	Facility		$51.82	$51.82	$51.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.22 / $38.22 / $38.22	Professional		$38.22	$38.22	$38.22
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $345.40 / $345.40	Professional		$120.00	$345.40	$345.40
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 / $40.00 / $2,500.00	Professional		$30.00	$40.00	$2,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $47.50 / $62.50 / $110.95	Professional		$47.50	$62.50	$110.95