Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $102.33	Facility		$64.57	$64.57	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $64.57 / $102.33	Professional		$57.54	$64.57	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $223.87	Professional		$102.33	$102.33	$223.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $489.78 / $537.03	Professional		$354.81	$489.78	$537.03
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 $208.93 / $295.12 / $295.12	Professional		$208.93	$295.12	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $74.13 / $123.03	Facility		$52.48	$74.13	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $131.83	Professional		$57.54	$75.86	$131.83