Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.53 / $17.53 / $17.53	Facility		$17.53	$17.53	$17.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.55 / $14.90 / $17.53	Professional		$14.55	$14.90	$17.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.05 / $62.05 / $62.05	Facility		$62.05	$62.05	$62.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $62.05 / $62.05	Professional		$62.05	$62.05	$62.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $113.27 / $113.27 / $121.27	Professional		$113.27	$113.27	$121.27
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $14.55 / $17.19 / $34.90	Facility		$14.55	$17.19	$34.90
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $34.97 / $34.97 / $34.97	Professional		$34.97	$34.97	$34.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $3,500.00	Professional		$30.00	$30.00	$3,500.00
United Facility/Professional Professional Modifier Low / Median / High Price $62.05 / $62.05 / $86.87	Professional		$62.05	$62.05	$86.87