Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.84 / $73.43 / $155.88	Facility		$66.84	$73.43	$155.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.69 / $66.84 / $81.30	Professional		$57.69	$66.84	$81.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.93 / $94.93 / $142.91	Professional		$94.93	$94.93	$142.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $69.93 / $105.60 / $160.91	Professional		$69.93	$105.60	$160.91
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 $89.70 / $95.46 / $142.96	Professional		$89.70	$95.46	$142.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $164.96	Professional		$32.34	$32.34	$164.96
United Facility/Professional Professional Modifier Low / Median / High Price $69.56 / $100.17 / $145.08	Professional		$69.56	$100.17	$145.08