Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $288.00 / $1,152.00	Facility		$144.00	$288.00	$1,152.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $230.40 / $230.40	Professional		$144.00	$230.40	$230.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $124.80 / $124.80 / $124.80	Facility		$124.80	$124.80	$124.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $595.20 / $625.91 / $625.91	Professional		$595.20	$625.91	$625.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $124.80 / $124.80 / $241.92	Facility		$124.80	$124.80	$241.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $202.56 / $202.56 / $460.80	Professional		$202.56	$202.56	$460.80
United Facility/Professional Professional Modifier Low / Median / High Price $80.64 / $80.64 / $115.20	Professional		$80.64	$80.64	$115.20