Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.25 / $562.50 / $1,125.00	Facility		$281.25	$562.50	$1,125.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.25 / $450.00 / $450.00	Professional		$281.25	$450.00	$450.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.75 / $243.75 / $243.75	Facility		$243.75	$243.75	$243.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $581.25 / $611.25 / $611.25	Professional		$581.25	$611.25	$611.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $243.75 / $375.00 / $472.50	Facility		$243.75	$375.00	$472.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $395.63 / $453.75 / $521.25	Professional		$395.63	$453.75	$521.25
United Facility/Professional Professional Modifier Low / Median / High Price $157.50 / $157.50 / $225.00	Professional		$157.50	$157.50	$225.00