Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.60 / $165.60 / $165.60	Facility		$165.60	$165.60	$165.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.22 / $226.05 / $866.08	Professional		$135.22	$226.05	$866.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.51 / $194.51 / $194.51	Facility		$194.51	$194.51	$194.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.99 / $194.51 / $194.51	Professional		$141.99	$194.51	$194.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $240.14 / $300.18 / $450.27	Professional		$240.14	$300.18	$450.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.51 / $72.51 / $225.59	Facility		$72.51	$72.51	$225.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.99 / $194.51 / $285.88	Professional		$141.99	$194.51	$285.88
United Facility/Professional Professional Modifier Low / Median / High Price $103.85 / $112.32 / $173.08	Professional		$103.85	$112.32	$173.08