Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $229.09 / $363.08	Professional		$165.96	$229.09	$363.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Facility		$251.19	$251.19	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $630.96	Professional		$181.97	$181.97	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $436.52 / $645.65	Professional		$346.74	$436.52	$645.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $316.23 / $436.52	Facility		$123.03	$316.23	$436.52
Providence Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $501.19	Professional		$181.97	$181.97	$501.19
United Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $213.80 / $524.81	Facility		$147.91	$213.80	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $190.55 / $288.40	Professional		$173.78	$190.55	$288.40