Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.45 / $295.45 / $295.45	Facility		$295.45	$295.45	$295.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.45 / $362.23 / $420.99	Professional		$295.45	$362.23	$420.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $438.02 / $636.02 / $879.40	Professional		$438.02	$636.02	$879.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $702.81	Professional		$50.00	$70.00	$702.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $330.96 / $366.49 / $431.17	Facility		$330.96	$366.49	$431.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $427.39 / $563.13 / $678.51	Professional		$427.39	$563.13	$678.51
United Facility/Professional Professional Modifier Low / Median / High Price $490.61 / $602.25 / $865.05	Professional		$490.61	$602.25	$865.05