Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $140.00 / $140.00	Facility		$140.00	$140.00	$140.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $140.00 / $140.00	Professional		$140.00	$140.00	$140.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.29 / $223.29 / $223.29	Facility		$223.29	$223.29	$223.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.00 / $163.00 / $223.29	Professional		$163.00	$163.00	$223.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $200.00 / $345.40	Professional		$100.00	$200.00	$345.40
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $224.26 / $261.63	Professional		$40.00	$224.26	$261.63
United Facility/Professional Professional Modifier Low / Median / High Price $142.21 / $170.65 / $298.64	Professional		$142.21	$170.65	$298.64