Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $168.01 / $168.01 / $168.01	Facility		$168.01	$168.01	$168.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.01 / $258.02 / $959.87	Professional		$168.01	$258.02	$959.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $227.96 / $227.96 / $227.96	Facility		$227.96	$227.96	$227.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.41 / $227.96 / $227.96	Professional		$166.41	$227.96	$227.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $274.10 / $342.63 / $513.94	Professional		$274.10	$342.63	$513.94
Providence Facility/Professional Facility Modifier Low / Median / High Price $98.06 / $98.06 / $257.49	Facility		$98.06	$98.06	$257.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $166.41 / $227.96 / $389.86	Professional		$166.41	$227.96	$389.86
United Facility/Professional Professional Modifier Low / Median / High Price $137.91 / $151.90 / $228.81	Professional		$137.91	$151.90	$228.81