Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.16 / $129.16 / $129.16	Facility		$129.16	$129.16	$129.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.65 / $176.31 / $695.70	Professional		$115.65	$176.31	$695.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.98 / $126.98 / $126.98	Facility		$126.98	$126.98	$126.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.70 / $92.70 / $290.97	Professional		$92.70	$92.70	$290.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $187.30 / $234.13 / $351.19	Professional		$187.30	$234.13	$351.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $62.01 / $62.01 / $175.94	Facility		$62.01	$62.01	$175.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $92.70 / $126.98 / $247.34	Professional		$92.70	$126.98	$247.34
United Facility/Professional Professional Modifier Low / Median / High Price $88.82 / $96.06 / $144.72	Professional		$88.82	$96.06	$144.72