Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.90 / $1,052.89 / $1,052.89	Facility		$1,047.90	$1,052.89	$1,052.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,052.89 / $1,052.89 / $1,095.00	Professional		$1,052.89	$1,052.89	$1,095.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,052.89 / $1,052.89 / $1,052.89	Facility		$1,052.89	$1,052.89	$1,052.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $998.00 / $1,052.89 / $1,052.89	Professional		$998.00	$1,052.89	$1,052.89
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $301.55 / $1,052.89 / $1,579.34	Professional		$301.55	$1,052.89	$1,579.34
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 $1,368.76 / $1,368.76 / $1,368.76	Professional		$1,368.76	$1,368.76	$1,368.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $40.00 / $441.26	Professional		$30.00	$40.00	$441.26
United Facility/Professional Professional Modifier Low / Median / High Price $1,052.89 / $1,052.89 / $1,117.11	Professional		$1,052.89	$1,052.89	$1,117.11