Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $302.00 / $363.08	Professional		$295.12	$302.00	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $60.26 / $107.15	Professional		$48.98	$60.26	$107.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $309.03 / $616.60	Facility		$295.12	$309.03	$616.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $275.42 / $275.42	Facility		$144.54	$275.42	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00