Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $906.54 / $906.54 / $906.54	Professional		$906.54	$906.54	$906.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $486.32 / $510.39 / $611.51	Professional		$486.32	$510.39	$611.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.00 / $345.40	Professional		$100.00	$125.00	$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 / $634.79	Professional		$30.00	$30.00	$634.79
United Facility/Professional Professional Modifier Low / Median / High Price $168.19 / $224.52 / $362.93	Professional		$168.19	$224.52	$362.93