Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.33 / $78.33 / $78.33	Facility		$78.33	$78.33	$78.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.33 / $120.29 / $753.23	Professional		$78.33	$120.29	$753.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $133.72 / $133.72	Facility		$133.72	$133.72	$133.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $133.72 / $133.72	Professional		$97.62	$133.72	$133.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $120.25 / $150.32 / $225.48	Professional		$120.25	$150.32	$225.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.06 / $63.06 / $147.13	Facility		$63.06	$63.06	$147.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $133.72 / $186.99	Professional		$97.62	$133.72	$186.99
United Facility/Professional Professional Modifier Low / Median / High Price $88.28 / $97.68 / $147.13	Professional		$88.28	$97.68	$147.13