Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $119.20 / $600.41	Professional		$72.00	$119.20	$600.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.17 / $52.17 / $52.17	Facility		$52.17	$52.17	$52.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $52.17 / $52.17	Professional		$38.08	$52.17	$52.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $88.13 / $125.91 / $188.86	Professional		$88.13	$125.91	$188.86
Providence Facility/Professional Facility Modifier Low / Median / High Price $28.81 / $28.81 / $52.17	Facility		$28.81	$28.81	$52.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $52.17 / $88.38	Professional		$38.08	$52.17	$88.38
United Facility/Professional Professional Modifier Low / Median / High Price $94.18 / $95.03 / $156.97	Professional		$94.18	$95.03	$156.97