Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.09 / $69.09 / $215.59	Facility		$69.09	$69.09	$215.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.09 / $69.09 / $69.09	Professional		$69.09	$69.09	$69.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.61 / $73.42 / $73.42	Professional		$55.61	$73.42	$73.42
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $69.09 / $86.38 / $192.27	Facility		$69.09	$86.38	$192.27
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $69.09 / $70.26 / $84.31	Professional		$69.09	$70.26	$84.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.96 / $63.96 / $63.96	Professional		$63.96	$63.96	$63.96
United Facility/Professional Facility Modifier Low / Median / High Price $58.90 / $58.90 / $58.90	Facility		$58.90	$58.90	$58.90
United Facility/Professional Professional Modifier Low / Median / High Price $71.98 / $71.98 / $73.43	Professional		$71.98	$71.98	$73.43