Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $395.90 / $791.80 / $1,583.61	Facility		$395.90	$791.80	$1,583.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $395.90 / $633.44 / $633.44	Professional		$395.90	$633.44	$633.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $343.12 / $343.12 / $343.12	Facility		$343.12	$343.12	$343.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $818.20 / $860.43 / $860.43	Professional		$818.20	$860.43	$860.43
Providence Facility/Professional Facility Modifier Low / Median / High Price $343.12 / $343.12 / $665.12	Facility		$343.12	$343.12	$665.12
Providence Facility/Professional Professional Modifier Low / Median / High Price $556.90 / $556.90 / $633.44	Professional		$556.90	$556.90	$633.44
United Facility/Professional Professional Modifier Low / Median / High Price $221.71 / $221.71 / $316.72	Professional		$221.71	$221.71	$316.72