Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.25 / $71.25 / $71.25	Facility		$71.25	$71.25	$71.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.25 / $62.25 / $71.25	Professional		$62.25	$62.25	$71.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $63.75 / $63.75	Facility		$63.75	$63.75	$63.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $63.75 / $63.75	Professional		$63.75	$63.75	$63.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.39 / $112.39 / $112.39	Professional		$112.39	$112.39	$112.39
Providence Facility/Professional Facility Modifier Low / Median / High Price $29.94 / $63.75 / $153.47	Facility		$29.94	$63.75	$153.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $63.75 / $63.75 / $63.75	Professional		$63.75	$63.75	$63.75
United Facility/Professional Professional Modifier Low / Median / High Price $62.50 / $62.50 / $62.50	Professional		$62.50	$62.50	$62.50