Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.35 / $17.35 / $17.35	Facility		$17.35	$17.35	$17.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.35 / $35.13 / $53.45	Professional		$17.35	$35.13	$53.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.15 / $35.15 / $35.15	Facility		$35.15	$35.15	$35.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.84 / $18.91 / $89.35	Professional		$9.84	$18.91	$89.35
Medcost Facility/Professional Facility Modifier Low / Median / High Price $17.35 / $35.36 / $43.63	Facility		$17.35	$35.36	$43.63
Medcost Facility/Professional Professional Modifier Low / Median / High Price $214.43 / $214.43 / $214.43	Professional		$214.43	$214.43	$214.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Professional		$30.00	$30.00	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $27.29 / $39.10 / $74.06	Professional		$27.29	$39.10	$74.06