Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $123.03 / $123.03	Facility		$54.95	$123.03	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $28.84 / $43.65	Professional		$22.91	$28.84	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $26.92 / $45.71	Facility		$26.92	$26.92	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $32.36 / $47.86	Professional		$12.30	$32.36	$47.86
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 $17.78 / $31.62 / $51.29	Facility		$17.78	$31.62	$51.29
Providence Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $37.15 / $66.07	Professional		$12.88	$37.15	$66.07
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 $10.23 / $16.60 / $17.78	Professional		$10.23	$16.60	$17.78