Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $810.04 / $810.04 / $810.04	Facility		$810.04	$810.04	$810.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $707.72 / $707.72 / $810.04	Professional		$707.72	$707.72	$810.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.77 / $724.77 / $724.77	Facility		$724.77	$724.77	$724.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $724.77 / $724.77 / $724.77	Professional		$724.77	$724.77	$724.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $217.57 / $217.57 / $217.57	Professional		$217.57	$217.57	$217.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $59.51 / $174.36 / $724.77	Facility		$59.51	$174.36	$724.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $724.77 / $724.77 / $724.77	Professional		$724.77	$724.77	$724.77
United Facility/Professional Professional Modifier Low / Median / High Price $710.56 / $710.56 / $710.56	Professional		$710.56	$710.56	$710.56