Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.97 / $106.97 / $117.65	Facility		$106.97	$106.97	$117.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $112.32	Professional		$106.97	$106.97	$112.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.97 / $106.97 / $106.97	Facility		$106.97	$106.97	$106.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $112.05	Professional		$106.97	$106.97	$112.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $90.92 / $117.67 / $259.19	Professional		$90.92	$117.67	$259.19
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 $139.06 / $139.06 / $139.06	Professional		$139.06	$139.06	$139.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $40.00 / $55.67	Professional		$30.00	$40.00	$55.67
United Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $113.50	Professional		$106.97	$106.97	$113.50