Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.00 / $173.00 / $173.00	Facility		$173.00	$173.00	$173.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.00 / $173.00 / $173.00	Professional		$173.00	$173.00	$173.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.02 / $263.02 / $263.02	Facility		$263.02	$263.02	$263.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.01 / $192.01 / $263.02	Professional		$192.01	$192.01	$263.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $161.35 / $218.40 / $233.62	Professional		$161.35	$218.40	$233.62
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 $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $614.21 / $614.21 / $614.21	Professional		$614.21	$614.21	$614.21