Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $323.59 / $602.56	Facility		$229.09	$323.59	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $213.80 / $288.40	Professional		$208.93	$213.80	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $416.87	Facility		$208.93	$208.93	$416.87
Providence Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $208.93 / $208.93	Professional		$199.53	$208.93	$208.93