Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,420.00 / $2,420.00 / $2,420.00	Facility		$2,420.00	$2,420.00	$2,420.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $327.43 / $327.43 / $390.48	Professional		$327.43	$327.43	$390.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $64.00 / $64.00	Facility		$64.00	$64.00	$64.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.31 / $310.31 / $310.31	Professional		$310.31	$310.31	$310.31
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $619.22 / $908.30 / $1,139.25	Professional		$619.22	$908.30	$1,139.25
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $2,500.00	Professional		$30.00	$30.00	$2,500.00