Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Facility		$45.00	$45.00	$45.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Professional		$45.00	$45.00	$45.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $379.93 / $379.93 / $379.93	Facility		$379.93	$379.93	$379.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.35 / $277.35 / $379.93	Professional		$277.35	$277.35	$379.93
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 $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $4,790.84 / $4,790.84 / $4,790.84	Professional		$4,790.84	$4,790.84	$4,790.84