Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.28 / $151.28 / $151.28	Facility		$151.28	$151.28	$151.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.96 / $232.32 / $890.09	Professional		$138.96	$232.32	$890.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.23 / $166.23 / $166.23	Facility		$166.23	$166.23	$166.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.35 / $166.23 / $166.23	Professional		$121.35	$166.23	$166.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $246.80 / $308.51 / $462.76	Professional		$246.80	$308.51	$462.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $74.52 / $74.52 / $231.84	Facility		$74.52	$74.52	$231.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $121.35 / $166.23 / $314.08	Professional		$121.35	$166.23	$314.08
United Facility/Professional Professional Modifier Low / Median / High Price $104.81 / $115.43 / $173.88	Professional		$104.81	$115.43	$173.88