Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.65 / $167.65 / $167.65	Facility		$167.65	$167.65	$167.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.65 / $167.65 / $178.13	Professional		$167.65	$167.65	$178.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.13 / $178.13 / $178.13	Professional		$178.13	$178.13	$178.13
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $167.65 / $205.37 / $209.56	Facility		$167.65	$205.37	$209.56
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $167.65 / $205.37 / $251.47	Professional		$167.65	$205.37	$251.47
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 Professional Modifier Low / Median / High Price $202.90 / $202.90 / $215.28	Professional		$202.90	$202.90	$215.28