Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.95 / $84.95 / $84.95	Facility		$84.95	$84.95	$84.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.19 / $84.95 / $125.20	Professional		$84.19	$84.95	$125.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $90.00 / $118.80	Professional		$90.00	$90.00	$118.80
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $84.95 / $92.75 / $106.66	Facility		$84.95	$92.75	$106.66
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $84.95 / $92.75 / $106.66	Professional		$84.95	$92.75	$106.66
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 $233.00 / $233.00 / $233.00	Facility		$233.00	$233.00	$233.00
United Facility/Professional Professional Modifier Low / Median / High Price $320.00 / $320.00 / $320.00	Professional		$320.00	$320.00	$320.00