Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $540.00 / $1,080.00 / $2,160.00	Facility		$540.00	$1,080.00	$2,160.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $540.00 / $540.00 / $540.00	Professional		$540.00	$540.00	$540.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $468.00 / $468.00 / $468.00	Facility		$468.00	$468.00	$468.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $827.24 / $827.24 / $1,034.05	Professional		$827.24	$827.24	$1,034.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,500.00 / $1,500.00 / $1,500.00	Professional		$1,500.00	$1,500.00	$1,500.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $468.00 / $684.00 / $864.00	Facility		$468.00	$684.00	$864.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $590.40 / $720.00 / $720.00	Professional		$590.40	$720.00	$720.00
United Facility/Professional Facility Modifier Low / Median / High Price $720.00 / $720.00 / $720.00	Facility		$720.00	$720.00	$720.00
United Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $302.39 / $432.00	Professional		$302.39	$302.39	$432.00