Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.38 / $79.70 / $167.90	Facility		$71.38	$79.70	$167.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.58 / $71.38 / $87.77	Professional		$59.58	$71.38	$87.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.67 / $102.67 / $154.91	Professional		$102.67	$102.67	$154.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $113.74 / $173.31	Professional		$76.09	$113.74	$173.31
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 $98.57 / $103.62 / $153.66	Professional		$98.57	$103.62	$153.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $177.32	Professional		$32.34	$32.34	$177.32
United Facility/Professional Professional Modifier Low / Median / High Price $68.41 / $97.39 / $148.37	Professional		$68.41	$97.39	$148.37