Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.21 / $46.21 / $46.21	Facility		$46.21	$46.21	$46.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.21 / $70.95 / $362.48	Professional		$46.21	$70.95	$362.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.37 / $81.37 / $81.37	Facility		$81.37	$81.37	$81.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.40 / $81.37 / $81.37	Professional		$59.40	$81.37	$81.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.38 / $94.23 / $141.34	Professional		$75.38	$94.23	$141.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.34 / $30.34 / $81.37	Facility		$30.34	$30.34	$81.37
Providence Facility/Professional Professional Modifier Low / Median / High Price $59.40 / $81.37 / $110.42	Professional		$59.40	$81.37	$110.42
United Facility/Professional Professional Modifier Low / Median / High Price $42.68 / $47.01 / $70.80	Professional		$42.68	$47.01	$70.80