Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.60 / $97.60 / $97.60	Facility		$97.60	$97.60	$97.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.60 / $149.88 / $689.21	Professional		$97.60	$149.88	$689.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.95 / $111.95 / $111.95	Facility		$111.95	$111.95	$111.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.72 / $111.94 / $111.95	Professional		$81.72	$111.94	$111.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $159.24 / $199.05 / $298.57	Professional		$159.24	$199.05	$298.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.70 / $57.70 / $149.58	Facility		$57.70	$57.70	$149.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $81.72 / $111.95 / $233.26	Professional		$81.72	$111.95	$233.26
United Facility/Professional Professional Modifier Low / Median / High Price $81.15 / $89.38 / $134.63	Professional		$81.15	$89.38	$134.63