Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $562.34 / $575.44	Facility		$257.04	$562.34	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $165.96 / $1,148.15	Professional		$120.23	$165.96	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $263.03 / $371.54	Professional		$154.88	$263.03	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $371.54	Professional		$269.15	$269.15	$371.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $316.23 / $512.86	Facility		$154.88	$316.23	$512.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $251.19 / $380.19	Professional		$154.88	$251.19	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $275.42	Professional		$104.71	$144.54	$275.42