Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.27 / $79.27 / $163.94	Facility		$79.27	$79.27	$163.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.27 / $108.67 / $131.15	Professional		$79.27	$108.67	$131.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.07 / $99.07 / $99.07	Facility		$99.07	$99.07	$99.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.60 / $185.34 / $256.05	Professional		$148.60	$185.34	$256.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $74.72 / $1,500.00	Professional		$32.34	$74.72	$1,500.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $111.48 / $148.83 / $186.93	Facility		$111.48	$148.83	$186.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $140.97 / $185.34 / $256.05	Professional		$140.97	$185.34	$256.05
United Facility/Professional Professional Modifier Low / Median / High Price $96.63 / $204.14 / $377.64	Professional		$96.63	$204.14	$377.64