Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.88 / $55.88 / $55.88	Facility		$55.88	$55.88	$55.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.88 / $85.81 / $375.66	Professional		$55.88	$85.81	$375.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.33 / $84.33 / $84.33	Facility		$84.33	$84.33	$84.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.56 / $84.33 / $84.33	Professional		$61.56	$84.33	$84.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.16 / $113.95 / $170.92	Professional		$91.16	$113.95	$170.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $36.70 / $36.70 / $85.63	Facility		$36.70	$36.70	$85.63
Providence Facility/Professional Professional Modifier Low / Median / High Price $61.56 / $84.33 / $141.28	Professional		$61.56	$84.33	$141.28
United Facility/Professional Professional Modifier Low / Median / High Price $51.62 / $56.85 / $85.63	Professional		$51.62	$56.85	$85.63