Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.93 / $89.93 / $89.93	Facility		$89.93	$89.93	$89.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.28 / $89.93 / $112.99	Professional		$63.28	$89.93	$112.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.34 / $112.34 / $112.34	Facility		$112.34	$112.34	$112.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.62 / $69.09 / $78.51	Professional		$28.62	$69.09	$78.51
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $89.93 / $100.44 / $100.44	Facility		$89.93	$100.44	$100.44
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $89.93 / $100.44 / $125.42	Professional		$89.93	$100.44	$125.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $116.84 / $170.40	Professional		$75.22	$116.84	$170.40