Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.62 / $90.62 / $90.62	Facility		$90.62	$90.62	$90.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $90.62 / $90.62	Professional		$87.98	$90.62	$90.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $122.82	Professional		$87.98	$87.98	$122.82
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $87.98 / $87.98 / $90.62	Facility		$87.98	$87.98	$90.62
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $118.77	Professional		$87.98	$87.98	$118.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $120.72 / $142.39	Professional		$87.98	$120.72	$142.39
United Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $93.35	Professional		$87.98	$87.98	$93.35