Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $120.00 / $120.00	Facility		$120.00	$120.00	$120.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $120.00 / $127.50	Professional		$120.00	$120.00	$127.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $135.00 / $150.00	Facility		$120.00	$135.00	$150.00
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $120.00 / $127.50	Professional		$120.00	$120.00	$127.50
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 $150.00 / $150.00 / $159.15	Professional		$150.00	$150.00	$159.15