Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $146.06 / $146.06 / $146.06	Facility		$146.06	$146.06	$146.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.00 / $127.61 / $146.06	Professional		$123.00	$127.61	$146.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.69 / $130.69 / $130.69	Facility		$130.69	$130.69	$130.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.69 / $130.69 / $130.69	Professional		$130.69	$130.69	$130.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $99.69	Professional		$60.00	$60.00	$99.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $62.99 / $130.69 / $153.75	Facility		$62.99	$130.69	$153.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $93.23 / $130.69 / $130.69	Professional		$93.23	$130.69	$130.69
United Facility/Professional Professional Modifier Low / Median / High Price $128.13 / $128.13 / $128.13	Professional		$128.13	$128.13	$128.13