Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.89 / $52.89 / $52.89	Facility		$52.89	$52.89	$52.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.89 / $81.23 / $302.13	Professional		$52.89	$81.23	$302.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.89 / $59.89 / $59.89	Facility		$59.89	$59.89	$59.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.72 / $59.89 / $59.89	Professional		$43.72	$59.89	$59.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $107.87 / $161.80	Professional		$86.29	$107.87	$161.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $30.87 / $30.87 / $81.05	Facility		$30.87	$30.87	$81.05
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.72 / $59.89 / $122.71	Professional		$43.72	$59.89	$122.71
United Facility/Professional Professional Modifier Low / Median / High Price $43.41 / $47.81 / $72.02	Professional		$43.41	$47.81	$72.02