Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $346.74	Professional		$162.18	$223.87	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $616.60	Professional		$169.82	$169.82	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $416.87 / $630.96	Professional		$338.84	$416.87	$630.96
Providence Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $309.03 / $426.58	Facility		$120.23	$309.03	$426.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $489.78	Professional		$169.82	$169.82	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $208.93 / $512.86	Facility		$144.54	$208.93	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $186.21 / $281.84	Professional		$169.82	$186.21	$281.84