Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $954.99	Professional		$91.20	$134.90	$954.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $154.88	Professional		$134.90	$134.90	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $75.86 / $323.59	Professional		$21.88	$75.86	$323.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $104.71 / $154.88	Facility		$60.26	$104.71	$154.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $134.90 / $154.88	Professional		$58.88	$134.90	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $85.11 / $147.91	Facility		$8.32	$85.11	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $141.25	Professional		$79.43	$93.33	$141.25