Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $186.21 / $288.40	Professional		$134.90	$186.21	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $512.86	Professional		$141.25	$141.25	$512.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $346.74 / $524.81	Professional		$275.42	$346.74	$524.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $251.19 / $380.19	Facility		$100.00	$251.19	$380.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $407.38	Professional		$141.25	$141.25	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $169.82 / $416.87	Facility		$117.49	$169.82	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $154.88 / $234.42	Professional		$141.25	$154.88	$234.42