Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.32 / $4,112.00 / $4,933.00	Facility		$169.32	$4,112.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.12 / $169.32 / $232.95	Professional		$119.12	$169.32	$232.95
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $399.98 / $4,112.00 / $4,933.00	Facility		$399.98	$4,112.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $169.32 / $399.98 / $464.55	Professional		$169.32	$399.98	$464.55
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 Facility Modifier Low / Median / High Price $300.00 / $1,386.00 / $2,449.00	Facility		$300.00	$1,386.00	$2,449.00
United Facility/Professional Professional Modifier Low / Median / High Price $182.98 / $406.90 / $632.24	Professional		$182.98	$406.90	$632.24