Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.45 / $77.45 / $156.05	Facility		$77.45	$77.45	$156.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.45 / $124.84 / $620.61	Professional		$77.45	$124.84	$620.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.73 / $194.73 / $194.73	Facility		$194.73	$194.73	$194.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.75 / $172.24 / $227.67	Professional		$149.75	$172.24	$227.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.56 / $32.34 / $152.58	Professional		$24.56	$32.34	$152.58
Providence Facility/Professional Facility Modifier Low / Median / High Price $121.28 / $183.16 / $194.73	Facility		$121.28	$183.16	$194.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.47 / $178.35 / $227.67	Professional		$141.47	$178.35	$227.67
United Facility/Professional Professional Modifier Low / Median / High Price $109.45 / $119.04 / $212.53	Professional		$109.45	$119.04	$212.53