Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.29 / $37.90 / $174.23	Professional		$28.29	$37.90	$174.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.90 / $39.90 / $39.90	Facility		$39.90	$39.90	$39.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $39.90 / $47.93	Professional		$39.90	$39.90	$47.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.33 / $61.67 / $92.50	Professional		$49.33	$61.67	$92.50
Providence Facility/Professional Facility Modifier Low / Median / High Price $20.12 / $31.37 / $47.51	Facility		$20.12	$31.37	$47.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $39.90 / $47.93	Professional		$39.90	$39.90	$47.93
United Facility/Professional Professional Modifier Low / Median / High Price $26.42 / $30.13 / $46.95	Professional		$26.42	$30.13	$46.95