Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $104.71 / $169.82	Facility		$66.07	$104.71	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $66.07 / $81.28	Professional		$57.54	$66.07	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $147.91	Professional		$95.50	$95.50	$147.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $154.88	Professional		$69.18	$102.33	$154.88
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 $89.13 / $95.50 / $144.54	Professional		$89.13	$95.50	$144.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Facility		$102.33	$102.33	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $100.00 / $141.25	Professional		$69.18	$100.00	$141.25