Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.91 / $131.83 / $263.64	Facility		$65.91	$131.83	$263.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.91 / $105.46 / $565.07	Professional		$65.91	$105.46	$565.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.12 / $57.12 / $57.12	Facility		$57.12	$57.12	$57.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.51 / $101.19 / $126.48	Professional		$40.51	$101.19	$126.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.33 / $48.33 / $48.33	Professional		$48.33	$48.33	$48.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.37 / $89.99 / $125.99	Facility		$57.37	$89.99	$125.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.42 / $87.88 / $120.85	Professional		$68.42	$87.88	$120.85
United Facility/Professional Professional Modifier Low / Median / High Price $36.90 / $38.32 / $52.73	Professional		$36.90	$38.32	$52.73