Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $381.36 / $592.70 / $592.70	Facility		$381.36	$592.70	$592.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $381.36 / $484.33 / $906.91	Professional		$381.36	$484.33	$906.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $381.36 / $381.36 / $381.36	Facility		$381.36	$381.36	$381.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $381.36 / $381.36 / $381.36	Professional		$381.36	$381.36	$381.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $357.07 / $357.07 / $357.07	Professional		$357.07	$357.07	$357.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $348.64 / $350.59 / $381.36	Facility		$348.64	$350.59	$381.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $381.36 / $381.36 / $381.36	Professional		$381.36	$381.36	$381.36
United Facility/Professional Facility Modifier Low / Median / High Price $374.36 / $374.36 / $617.69	Facility		$374.36	$374.36	$617.69
United Facility/Professional Professional Modifier Low / Median / High Price $381.36 / $381.36 / $381.36	Professional		$381.36	$381.36	$381.36