Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $489.78 / $602.56	Facility		$478.63	$489.78	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $177.83	Professional		$112.20	$141.25	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $257.04 / $436.52	Facility		$131.83	$257.04	$436.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $173.78 / $213.80	Professional		$162.18	$173.78	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $89.13	Professional		$63.10	$69.18	$89.13