Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $384.00 / $384.00 / $384.00	Facility		$384.00	$384.00	$384.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $384.00 / $384.00 / $408.00	Professional		$384.00	$384.00	$408.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.25 / $408.00 / $408.00	Professional		$191.25	$408.00	$408.00
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $202.50 / $225.00 / $384.00	Facility		$202.50	$225.00	$384.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $384.00 / $384.00 / $408.00	Professional		$384.00	$384.00	$408.00
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 $480.00 / $480.00 / $509.28	Professional		$480.00	$480.00	$509.28