Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.98 / $87.98 / $124.49	Facility		$87.98	$87.98	$124.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $96.77	Professional		$87.98	$87.98	$96.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.98 / $87.98 / $87.98	Facility		$87.98	$87.98	$87.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $87.98	Professional		$87.98	$87.98	$87.98
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $78.52 / $123.17 / $277.80	Professional		$78.52	$123.17	$277.80
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 $114.37 / $114.37 / $114.37	Professional		$114.37	$114.37	$114.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $40.00 / $139.55	Professional		$30.00	$40.00	$139.55
United Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $91.53	Professional		$87.98	$87.98	$91.53