Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $156.15 / $156.15 / $156.15	Facility		$156.15	$156.15	$156.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.34 / $175.33 / $222.45	Professional		$115.34	$175.33	$222.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.62 / $336.48 / $515.16	Professional		$200.62	$336.48	$515.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $211.18	Professional		$50.00	$70.00	$211.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $105.80 / $174.89 / $222.45	Facility		$105.80	$174.89	$222.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $200.62 / $286.01 / $417.10	Professional		$200.62	$286.01	$417.10
United Facility/Professional Professional Modifier Low / Median / High Price $157.91 / $242.33 / $473.71	Professional		$157.91	$242.33	$473.71