Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.63 / $102.47 / $102.47	Facility		$65.63	$102.47	$102.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $83.35 / $147.24	Professional		$65.63	$83.35	$147.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.63 / $65.63 / $65.63	Facility		$65.63	$65.63	$65.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $65.63 / $65.63	Professional		$65.63	$65.63	$65.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.85 / $52.85 / $52.85	Professional		$52.85	$52.85	$52.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.75 / $48.68 / $65.63	Facility		$42.75	$48.68	$65.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $65.63 / $65.63	Professional		$65.63	$65.63	$65.63
United Facility/Professional Facility Modifier Low / Median / High Price $63.88 / $63.88 / $105.40	Facility		$63.88	$63.88	$105.40
United Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $65.63 / $65.63	Professional		$65.63	$65.63	$65.63