Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Facility		$42.66	$42.66	$42.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $45.71 / $75.86	Professional		$34.67	$45.71	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $114.82	Professional		$35.48	$35.48	$114.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $117.49	Professional		$63.10	$77.62	$117.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $58.88 / $102.33	Facility		$25.12	$58.88	$102.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $93.33	Professional		$35.48	$35.48	$93.33
United Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $58.88 / $107.15	Facility		$30.20	$58.88	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $42.66 / $58.88	Professional		$35.48	$42.66	$58.88