Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.33 / $170.33 / $170.33	Facility		$170.33	$170.33	$170.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.33 / $261.58 / $972.99	Professional		$170.33	$261.58	$972.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.91 / $192.91 / $192.91	Facility		$192.91	$192.91	$192.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.82 / $192.91 / $204.15	Professional		$140.82	$192.91	$204.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $277.88 / $347.36 / $521.04	Professional		$277.88	$347.36	$521.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $99.43 / $99.43 / $261.02	Facility		$99.43	$99.43	$261.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $140.82 / $192.91 / $395.20	Professional		$140.82	$192.91	$395.20
United Facility/Professional Professional Modifier Low / Median / High Price $139.85 / $154.02 / $232.01	Professional		$139.85	$154.02	$232.01