Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $395.73 / $395.73 / $395.73	Facility		$395.73	$395.73	$395.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $345.74 / $345.74 / $395.73	Professional		$345.74	$345.74	$395.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $367.96 / $367.96 / $367.96	Facility		$367.96	$367.96	$367.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $367.96 / $367.96 / $367.96	Professional		$367.96	$367.96	$367.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $280.49 / $280.49 / $280.49	Professional		$280.49	$280.49	$280.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $220.97 / $247.33 / $367.96	Facility		$220.97	$247.33	$367.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $367.96 / $367.96 / $367.96	Professional		$367.96	$367.96	$367.96
United Facility/Professional Professional Modifier Low / Median / High Price $357.54 / $357.54 / $357.54	Professional		$357.54	$357.54	$357.54