Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $72.44 / $125.89	Facility		$46.77	$72.44	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $45.71 / $61.66	Professional		$39.81	$45.71	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $112.20	Professional		$72.44	$72.44	$112.20
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $75.86 / $120.23	Professional		$50.12	$75.86	$120.23
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 $64.57 / $69.18 / $107.15	Professional		$64.57	$69.18	$107.15
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 $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $67.61 / $95.50	Professional		$46.77	$67.61	$95.50