Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $162.18	Professional		$81.28	$107.15	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $338.84	Professional		$81.28	$81.28	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $302.00	Professional		$158.49	$199.53	$302.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $147.91 / $229.09	Facility		$57.54	$147.91	$229.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $245.47	Professional		$81.28	$81.28	$245.47
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $100.00 / $245.47	Facility		$69.18	$100.00	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $89.13 / $134.90	Professional		$81.28	$89.13	$134.90