Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.00 / $88.00 / $88.00	Facility		$88.00	$88.00	$88.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $88.00 / $160.75	Professional		$88.00	$88.00	$160.75
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $88.00 / $88.00 / $88.00	Facility		$88.00	$88.00	$88.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $88.00 / $89.28	Professional		$88.00	$88.00	$89.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $100.00	Professional		$30.00	$30.00	$100.00