Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $248.25 / $496.50 / $993.00	Facility		$248.25	$496.50	$993.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.25 / $397.20 / $2,128.33	Professional		$248.25	$397.20	$2,128.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $215.15 / $215.15 / $215.15	Facility		$215.15	$215.15	$215.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.43 / $296.43 / $375.62	Professional		$296.43	$296.43	$375.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $513.04 / $539.53 / $539.53	Professional		$513.04	$539.53	$539.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $93.94 / $215.15 / $417.06	Facility		$93.94	$215.15	$417.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $296.43 / $400.51 / $460.09	Professional		$296.43	$400.51	$460.09
United Facility/Professional Facility Modifier Low / Median / High Price $297.89 / $297.89 / $297.89	Facility		$297.89	$297.89	$297.89
United Facility/Professional Professional Modifier Low / Median / High Price $108.81 / $108.81 / $198.60	Professional		$108.81	$108.81	$198.60