Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $602.56 / $1,148.15	Facility		$426.58	$602.56	$1,148.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $512.86	Professional		$389.05	$389.05	$512.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $467.74 / $562.34	Facility		$389.05	$467.74	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Professional		$389.05	$389.05	$389.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $389.05 / $562.34	Professional		$371.54	$389.05	$562.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $389.05 / $616.60	Facility		$251.19	$389.05	$616.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $389.05 / $467.74	Professional		$389.05	$389.05	$467.74
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $389.05	Facility		$389.05	$389.05	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $389.05 / $416.87	Professional		$371.54	$389.05	$416.87