Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $206.59 / $322.12 / $322.12	Facility		$206.59	$322.12	$322.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.59 / $262.37 / $457.16	Professional		$206.59	$262.37	$457.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $206.59 / $206.59 / $206.59	Facility		$206.59	$206.59	$206.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.59 / $206.59 / $206.59	Professional		$206.59	$206.59	$206.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.44 / $156.44 / $156.44	Professional		$156.44	$156.44	$156.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $153.62 / $206.59 / $206.59	Facility		$153.62	$206.59	$206.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $206.59 / $206.59 / $206.59	Professional		$206.59	$206.59	$206.59
United Facility/Professional Professional Modifier Low / Median / High Price $206.59 / $206.59 / $206.59	Professional		$206.59	$206.59	$206.59