Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,296.00 / $1,296.00 / $1,296.00	Facility		$1,296.00	$1,296.00	$1,296.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,296.00 / $1,296.00 / $1,377.00	Professional		$1,296.00	$1,296.00	$1,377.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,377.00 / $1,377.00 / $1,377.00	Professional		$1,377.00	$1,377.00	$1,377.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $1,296.00 / $1,296.00 / $1,296.00	Facility		$1,296.00	$1,296.00	$1,296.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $1,296.00 / $1,296.00 / $1,377.00	Professional		$1,296.00	$1,296.00	$1,377.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $100.00	Professional		$30.00	$30.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,350.00 / $1,350.00 / $1,432.35	Professional		$1,350.00	$1,350.00	$1,432.35