Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.00 / $79.00 / $79.00	Facility		$79.00	$79.00	$79.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.00 / $79.00	Professional		$79.00	$79.00	$79.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.10 / $86.10 / $86.10	Professional		$86.10	$86.10	$86.10
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $79.00 / $88.85 / $88.85	Facility		$79.00	$88.85	$88.85
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $88.85 / $106.62	Professional		$79.00	$88.85	$106.62
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 $195.94 / $221.41 / $235.13	Professional		$195.94	$221.41	$235.13