Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $83.18 / $125.89	Professional		$54.95	$83.18	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $204.17	Professional		$66.07	$66.07	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $251.19	Professional		$134.90	$169.82	$251.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $120.23 / $169.82	Facility		$44.67	$120.23	$169.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $165.96	Professional		$66.07	$66.07	$165.96
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 / $69.18 / $104.71	Professional		$63.10	$69.18	$104.71