Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.50 / $225.00 / $450.00	Facility		$112.50	$225.00	$450.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.50 / $180.00 / $964.50	Professional		$112.50	$180.00	$964.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.50 / $97.50 / $97.50	Facility		$97.50	$97.50	$97.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.26 / $134.26 / $170.40	Professional		$134.26	$134.26	$170.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $232.50 / $244.50 / $244.50	Professional		$232.50	$244.50	$244.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $97.50 / $189.00 / $296.24	Facility		$97.50	$189.00	$296.24
Providence Facility/Professional Professional Modifier Low / Median / High Price $172.50 / $189.75 / $216.00	Professional		$172.50	$189.75	$216.00
United Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $63.00 / $90.00	Professional		$63.00	$63.00	$90.00