Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $543.75 / $1,087.50 / $2,175.00	Facility		$543.75	$1,087.50	$2,175.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $543.75 / $543.75 / $543.75	Professional		$543.75	$543.75	$543.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $471.25 / $471.25 / $471.25	Facility		$471.25	$471.25	$471.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,123.75 / $1,181.75 / $1,181.75	Professional		$1,123.75	$1,181.75	$1,181.75
Providence Facility/Professional Facility Modifier Low / Median / High Price $471.25 / $471.25 / $913.50	Facility		$471.25	$471.25	$913.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $764.88 / $764.88 / $870.00	Professional		$764.88	$764.88	$870.00
United Facility/Professional Professional Modifier Low / Median / High Price $304.50 / $304.50 / $435.00	Professional		$304.50	$304.50	$435.00