Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.00 / $103.16 / $463.97	Professional		$77.00	$103.16	$463.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.50 / $111.50 / $111.50	Facility		$111.50	$111.50	$111.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.50 / $111.50 / $129.57	Professional		$111.50	$111.50	$129.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.03 / $24.43 / $192.16	Professional		$13.03	$24.43	$192.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.66 / $88.56 / $129.31	Facility		$57.66	$88.56	$129.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $111.50 / $111.50 / $129.57	Professional		$111.50	$111.50	$129.57
United Facility/Professional Professional Modifier Low / Median / High Price $75.69 / $82.57 / $134.54	Professional		$75.69	$82.57	$134.54