Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.75 / $96.75 / $96.75	Facility		$96.75	$96.75	$96.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.75 / $96.75 / $102.80	Professional		$96.75	$96.75	$102.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.80 / $102.80 / $102.80	Professional		$102.80	$102.80	$102.80
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $96.75 / $118.52 / $120.94	Facility		$96.75	$118.52	$120.94
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $96.75 / $118.52 / $145.12	Professional		$96.75	$118.52	$145.12
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 $100.78 / $100.78 / $106.93	Professional		$100.78	$100.78	$106.93