Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.36 / $115.36 / $115.36	Facility		$115.36	$115.36	$115.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.98 / $177.16 / $574.60	Professional		$105.98	$177.16	$574.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.82 / $121.82 / $121.82	Facility		$121.82	$121.82	$121.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $121.82 / $121.82	Professional		$88.93	$121.82	$121.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $188.20 / $235.26 / $352.89	Professional		$188.20	$235.26	$352.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $56.83 / $56.83 / $176.80	Facility		$56.83	$56.83	$176.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $121.82 / $206.77	Professional		$88.93	$121.82	$206.77
United Facility/Professional Professional Modifier Low / Median / High Price $79.92 / $88.03 / $132.60	Professional		$79.92	$88.03	$132.60