Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.38 / $128.38 / $128.38	Facility		$128.38	$128.38	$128.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.54 / $117.54 / $128.38	Professional		$117.54	$117.54	$128.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.69 / $128.69 / $128.69	Facility		$128.69	$128.69	$128.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.69 / $128.69 / $128.69	Professional		$128.69	$128.69	$128.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $157.00 / $1,500.00	Professional		$60.00	$157.00	$1,500.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.69 / $200.81 / $348.56	Facility		$128.69	$200.81	$348.56
Providence Facility/Professional Professional Modifier Low / Median / High Price $128.69 / $128.69 / $128.69	Professional		$128.69	$128.69	$128.69
United Facility/Professional Professional Modifier Low / Median / High Price $259.31 / $259.31 / $259.31	Professional		$259.31	$259.31	$259.31