Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $199.53 / $204.17	Facility		$93.33	$199.53	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $407.38	Professional		$42.66	$58.88	$407.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $69.18	Professional		$54.95	$54.95	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $131.83	Professional		$95.50	$95.50	$131.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $79.43 / $181.97	Facility		$41.69	$79.43	$181.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $77.62 / $89.13	Professional		$54.95	$77.62	$89.13
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $37.15	Professional		$25.70	$25.70	$37.15