Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $120.23 / $239.88	Professional		$97.72	$120.23	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $331.13	Professional		$100.00	$100.00	$331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $223.87 / $331.13	Professional		$177.83	$223.87	$331.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $165.96 / $263.03	Facility		$69.18	$165.96	$263.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $275.42	Professional		$100.00	$100.00	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $120.23 / $295.12	Facility		$83.18	$120.23	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $107.15 / $162.18	Professional		$97.72	$107.15	$162.18