Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $263.03 / $263.03	Facility		$120.23	$263.03	$263.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $64.57 / $97.72	Professional		$51.29	$64.57	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $97.72	Facility		$57.54	$57.54	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $69.18 / $104.71	Professional		$28.18	$69.18	$104.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $70.79	Professional		$50.12	$60.26	$70.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $77.62 / $151.36	Facility		$50.12	$77.62	$151.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $79.43 / $138.04	Professional		$28.18	$79.43	$138.04
United Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $741.31 / $741.31	Facility		$338.84	$741.31	$741.31
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $35.48 / $38.02	Professional		$23.99	$35.48	$38.02