Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.43 / $90.43 / $186.21	Facility		$90.43	$90.43	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.43 / $148.97 / $705.83	Professional		$90.43	$148.97	$705.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.26 / $94.26 / $94.26	Facility		$94.26	$94.26	$94.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.69 / $213.88 / $286.01	Professional		$175.69	$213.88	$286.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $44.03 / $133.28	Professional		$32.34	$44.03	$133.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $126.62 / $235.68 / $276.38	Facility		$126.62	$235.68	$276.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $168.80 / $212.82 / $286.01	Professional		$168.80	$212.82	$286.01
United Facility/Professional Professional Modifier Low / Median / High Price $106.75 / $145.91 / $244.90	Professional		$106.75	$145.91	$244.90