Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $787.50 / $1,575.00 / $3,150.00	Facility		$787.50	$1,575.00	$3,150.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $787.50 / $1,260.00 / $6,751.50	Professional		$787.50	$1,260.00	$6,751.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $682.50 / $682.50 / $682.50	Facility		$682.50	$682.50	$682.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $940.76 / $1,206.36 / $1,507.97	Professional		$940.76	$1,206.36	$1,507.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $577.50 / $1,627.50 / $1,711.50	Professional		$577.50	$1,627.50	$1,711.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $661.50 / $997.50 / $1,260.00	Facility		$661.50	$997.50	$1,260.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $854.73 / $1,207.50 / $1,459.50	Professional		$854.73	$1,207.50	$1,459.50
United Facility/Professional Professional Modifier Low / Median / High Price $437.79 / $437.79 / $630.00	Professional		$437.79	$437.79	$630.00