Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.36 / $124.36 / $124.36	Facility		$124.36	$124.36	$124.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.36 / $190.98 / $807.75	Professional		$124.36	$190.98	$807.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.66 / $139.66 / $139.66	Facility		$139.66	$139.66	$139.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.95 / $139.66 / $139.66	Professional		$101.95	$139.66	$139.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $202.88 / $253.61 / $380.41	Professional		$202.88	$253.61	$380.41
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.63 / $67.63 / $190.59	Facility		$67.63	$67.63	$190.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $101.95 / $139.66 / $246.06	Professional		$101.95	$139.66	$246.06
United Facility/Professional Professional Modifier Low / Median / High Price $95.11 / $104.75 / $157.80	Professional		$95.11	$104.75	$157.80