Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.45 / $123.45 / $123.45	Facility		$123.45	$123.45	$123.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.45 / $168.53 / $860.91	Professional		$123.45	$168.53	$860.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.96 / $169.96 / $169.96	Facility		$169.96	$169.96	$169.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.07 / $124.07 / $302.50	Professional		$124.07	$124.07	$302.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $179.03 / $223.79 / $335.68	Professional		$179.03	$223.79	$335.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.08 / $72.08 / $169.96	Facility		$72.08	$72.08	$169.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $124.07 / $169.96 / $345.76	Professional		$124.07	$169.96	$345.76
United Facility/Professional Professional Modifier Low / Median / High Price $103.22 / $127.81 / $172.04	Professional		$103.22	$127.81	$172.04