Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.58 / $164.58 / $164.58	Facility		$164.58	$164.58	$164.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.98 / $150.69 / $164.58	Professional		$97.98	$150.69	$164.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $183.96 / $183.96 / $260.73	Facility		$183.96	$183.96	$260.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.96 / $183.96 / $183.96	Professional		$183.96	$183.96	$183.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $68.20 / $1,500.00	Professional		$60.00	$68.20	$1,500.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.90 / $171.19 / $248.86	Facility		$114.90	$171.19	$248.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $183.96 / $183.96 / $183.96	Professional		$183.96	$183.96	$183.96
United Facility/Professional Professional Modifier Low / Median / High Price $215.05 / $215.05 / $215.05	Professional		$215.05	$215.05	$215.05