Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.35 / $137.35 / $137.35	Facility		$137.35	$137.35	$137.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.80 / $137.35 / $165.83	Professional		$101.80	$137.35	$165.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.58 / $200.58 / $200.58	Facility		$200.58	$200.58	$200.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
Medcost Facility/Professional Facility Modifier Low / Median / High Price $137.35 / $163.51 / $245.27	Facility		$137.35	$163.51	$245.27
Medcost Facility/Professional Professional Modifier Low / Median / High Price $165.83 / $165.83 / $165.83	Professional		$165.83	$165.83	$165.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.54 / $192.31 / $201.92	Professional		$120.54	$192.31	$201.92
United Facility/Professional Professional Modifier Low / Median / High Price $315.44 / $342.87 / $377.16	Professional		$315.44	$342.87	$377.16