Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $197.44 / $197.44 / $197.44	Facility		$197.44	$197.44	$197.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.44 / $269.52 / $1,091.58	Professional		$197.44	$269.52	$1,091.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $297.81 / $297.81 / $297.81	Facility		$297.81	$297.81	$297.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.40 / $297.81 / $297.81	Professional		$217.40	$297.81	$297.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $286.32 / $357.90 / $536.85	Professional		$286.32	$357.90	$536.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $115.27 / $115.27 / $297.81	Facility		$115.27	$115.27	$297.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $217.40 / $297.81 / $419.41	Professional		$217.40	$297.81	$419.41
United Facility/Professional Professional Modifier Low / Median / High Price $165.08 / $178.55 / $268.95	Professional		$165.08	$178.55	$268.95