Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $346.74	Professional		$158.49	$199.53	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $575.44	Professional		$165.96	$165.96	$575.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $354.81 / $537.03	Professional		$288.40	$354.81	$537.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $269.15 / $489.78	Facility		$114.82	$269.15	$489.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $549.54	Professional		$165.96	$165.96	$549.54
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $199.53 / $489.78	Facility		$138.04	$199.53	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $177.83 / $269.15	Professional		$162.18	$177.83	$269.15