Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.15 / $71.15 / $71.15	Facility		$71.15	$71.15	$71.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.15 / $109.26 / $549.51	Professional		$71.15	$109.26	$549.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.79 / $128.79 / $128.79	Facility		$128.79	$128.79	$128.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.02 / $128.79 / $128.79	Professional		$94.02	$128.79	$128.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.52 / $136.91 / $205.36	Professional		$109.52	$136.91	$205.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.29 / $39.29 / $128.79	Facility		$39.29	$39.29	$128.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.98 / $128.79 / $148.07	Professional		$80.98	$128.79	$148.07
United Facility/Professional Professional Modifier Low / Median / High Price $81.88 / $86.98 / $136.46	Professional		$81.88	$86.98	$136.46