Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.48 / $260.45 / $260.45	Facility		$170.48	$260.45	$260.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $216.50 / $1,124.66	Professional		$170.48	$216.50	$1,124.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.48 / $170.48 / $170.48	Facility		$170.48	$170.48	$170.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $170.48	Professional		$170.48	$170.48	$170.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $339.61 / $339.61 / $339.61	Professional		$339.61	$339.61	$339.61
Providence Facility/Professional Facility Modifier Low / Median / High Price $130.63 / $154.96 / $238.08	Facility		$130.63	$154.96	$238.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $170.48	Professional		$170.48	$170.48	$170.48
United Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $170.48 / $170.48	Professional		$170.48	$170.48	$170.48