Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.93 / $95.93 / $194.88	Facility		$95.93	$95.93	$194.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.93 / $155.90 / $155.90	Professional		$95.93	$155.90	$155.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.55 / $69.55 / $69.55	Facility		$69.55	$69.55	$69.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.38 / $254.67 / $396.10	Professional		$119.38	$254.67	$396.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $64.86 / $151.80	Professional		$32.34	$64.86	$151.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $113.34 / $396.89 / $584.38	Facility		$113.34	$396.89	$584.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $160.85 / $264.86 / $354.38	Professional		$160.85	$264.86	$354.38
United Facility/Professional Facility Modifier Low / Median / High Price $6,212.47 / $6,212.47 / $13,766.26	Facility		$6,212.47	$6,212.47	$13,766.26
United Facility/Professional Professional Modifier Low / Median / High Price $143.28 / $264.73 / $379.20	Professional		$143.28	$264.73	$379.20