Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.99 / $125.99 / $125.99	Facility		$125.99	$125.99	$125.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.99 / $193.48 / $972.99	Professional		$125.99	$193.48	$972.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.82 / $211.82 / $211.82	Facility		$211.82	$211.82	$211.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.63 / $211.82 / $211.82	Professional		$154.63	$211.82	$211.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $163.63 / $204.55 / $306.82	Professional		$163.63	$204.55	$306.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.56 / $69.56 / $211.82	Facility		$69.56	$69.56	$211.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $143.38 / $211.82 / $262.19	Professional		$143.38	$211.82	$262.19
United Facility/Professional Professional Modifier Low / Median / High Price $144.97 / $154.02 / $241.63	Professional		$144.97	$154.02	$241.63