Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $397.69 / $397.69 / $397.69	Facility		$397.69	$397.69	$397.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $256.08 / $257.64 / $357.13	Professional		$256.08	$257.64	$357.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $249.61 / $256.08 / $310.51	Facility		$249.61	$256.08	$310.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.08 / $256.08 / $256.08	Professional		$256.08	$256.08	$256.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $248.41 / $335.35 / $434.71	Professional		$248.41	$335.35	$434.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $249.61 / $256.08 / $325.23	Facility		$249.61	$256.08	$325.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $256.08 / $256.08 / $310.51	Professional		$256.08	$256.08	$310.51
United Facility/Professional Professional Modifier Low / Median / High Price $256.08 / $256.08 / $271.45	Professional		$256.08	$256.08	$271.45