Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $83.18 / $128.82	Professional		$61.66	$83.18	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $275.42	Professional		$64.57	$64.57	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $208.93	Professional		$112.20	$141.25	$208.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $104.71 / $169.82	Facility		$45.71	$104.71	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $169.82	Professional		$64.57	$64.57	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $77.62 / $190.55	Facility		$53.70	$77.62	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $70.79 / $104.71	Professional		$63.10	$70.79	$104.71