Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.23 / $83.23 / $83.23	Facility		$83.23	$83.23	$83.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $127.81 / $489.69	Professional		$76.45	$127.81	$489.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.21 / $104.21 / $104.21	Facility		$104.21	$104.21	$104.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $76.06 / $182.06	Professional		$76.06	$76.06	$182.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $135.78 / $169.73 / $254.59	Professional		$135.78	$169.73	$254.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.00 / $41.00 / $127.55	Facility		$41.00	$41.00	$127.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $104.21 / $152.75	Professional		$76.06	$104.21	$152.75
United Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $63.50 / $95.66	Professional		$57.66	$63.50	$95.66