Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.36 / $36.10 / $38.75	Facility		$20.36	$36.10	$38.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $30.00 / $39.14	Professional		$20.00	$30.00	$39.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.97 / $18.97 / $28.79	Professional		$18.97	$18.97	$28.79
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $21.25 / $25.00 / $47.63	Professional		$21.25	$25.00	$47.63
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 $32.50 / $32.50 / $32.50	Professional		$32.50	$32.50	$32.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $2,500.00	Professional		$30.00	$30.00	$2,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $22.50 / $29.70 / $52.61	Professional		$22.50	$29.70	$52.61