Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.00 / $53.00 / $1,197.00	Facility		$53.00	$53.00	$1,197.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $53.00 / $58.30	Professional		$53.00	$53.00	$58.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.00 / $53.00 / $53.00	Facility		$53.00	$53.00	$53.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $53.00 / $84.43	Professional		$53.00	$53.00	$84.43
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $47.70 / $74.20 / $320.35	Professional		$47.70	$74.20	$320.35
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 $68.90 / $68.90 / $68.90	Professional		$68.90	$68.90	$68.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $134.79 / $138.75 / $148.66	Professional		$134.79	$138.75	$148.66
United Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $53.00 / $58.11	Professional		$53.00	$53.00	$58.11