Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.00 / $1,619.00 / $2,060.00	Facility		$275.00	$1,619.00	$2,060.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.01 / $275.00 / $275.00	Professional		$164.01	$275.00	$275.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $407.89 / $427.10 / $443.08	Facility		$407.89	$427.10	$443.08
Medcost Facility/Professional Facility Modifier Low / Median / High Price $203.19 / $207.56 / $412.79	Facility		$203.19	$207.56	$412.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $65.98 / $65.98 / $410.84	Professional		$65.98	$65.98	$410.84
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 $193.50 / $263.75 / $422.09	Professional		$193.50	$263.75	$422.09