Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.19 / $216.19 / $216.19	Facility		$216.19	$216.19	$216.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $140.06 / $194.14	Professional		$139.21	$140.06	$194.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.99 / $139.21 / $170.54	Facility		$136.99	$139.21	$170.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $139.21	Professional		$139.21	$139.21	$139.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $136.43 / $140.52 / $222.02	Professional		$136.43	$140.52	$222.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.77 / $139.21 / $176.80	Facility		$63.77	$139.21	$176.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $170.54	Professional		$139.21	$139.21	$170.54
United Facility/Professional Professional Modifier Low / Median / High Price $139.21 / $139.21 / $147.56	Professional		$139.21	$139.21	$147.56