Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.50 / $125.50 / $125.50	Facility		$125.50	$125.50	$125.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.50 / $192.73 / $984.58	Professional		$125.50	$192.73	$984.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $159.91 / $159.91 / $159.91	Facility		$159.91	$159.91	$159.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.74 / $116.74 / $416.18	Professional		$116.74	$116.74	$416.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $204.74 / $255.93 / $383.89	Professional		$204.74	$255.93	$383.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $82.43 / $82.43 / $192.33	Facility		$82.43	$82.43	$192.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $116.74 / $159.91 / $328.37	Professional		$116.74	$159.91	$328.37
United Facility/Professional Professional Modifier Low / Median / High Price $115.93 / $127.68 / $192.33	Professional		$115.93	$127.68	$192.33