Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.96 / $103.96 / $103.96	Facility		$103.96	$103.96	$103.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.96 / $159.66 / $529.45	Professional		$103.96	$159.66	$529.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.53 / $116.53 / $116.53	Facility		$116.53	$116.53	$116.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.07 / $85.07 / $221.41	Professional		$85.07	$85.07	$221.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $169.61 / $212.02 / $318.02	Professional		$169.61	$212.02	$318.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $58.02 / $58.02 / $159.34	Facility		$58.02	$58.02	$159.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $85.07 / $116.53 / $258.45	Professional		$85.07	$116.53	$258.45
United Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $89.87 / $135.38	Professional		$81.59	$89.87	$135.38