Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,762.09 / $4,933.00 / $4,933.00	Facility		$1,762.09	$4,933.00	$4,933.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,112.66 / $1,762.09 / $1,762.09	Professional		$1,112.66	$1,762.09	$1,762.09
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,672.79 / $4,933.00 / $4,933.00	Facility		$1,672.79	$4,933.00	$4,933.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,672.79 / $1,673.89 / $2,127.48	Professional		$1,672.79	$1,673.89	$2,127.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $55.00	Professional		$30.00	$30.00	$55.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,906.00 / $4,645.00 / $6,740.00	Facility		$1,906.00	$4,645.00	$6,740.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,071.76 / $2,726.25 / $3,517.74	Professional		$2,071.76	$2,726.25	$3,517.74