Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $257.04	Professional		$120.23	$158.49	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $426.58	Professional		$120.23	$120.23	$426.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $398.11	Professional		$213.80	$269.15	$398.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $199.53 / $363.08	Facility		$85.11	$199.53	$363.08
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $331.13	Professional		$120.23	$120.23	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $147.91 / $363.08	Facility		$102.33	$147.91	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $131.83 / $199.53	Professional		$120.23	$131.83	$199.53