Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $42.75 / $47.50	Professional		$12.00	$42.75	$47.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.96 / $8.96 / $8.96	Professional		$8.96	$8.96	$8.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $152.68 / $201.52 / $377.20	Professional		$152.68	$201.52	$377.20
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $214.53 / $233.51 / $261.98	Professional		$214.53	$233.51	$261.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $2,500.00 / $2,500.00	Professional		$1,500.00	$2,500.00	$2,500.00