Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $288.40	Professional		$112.20	$165.96	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $512.86	Professional		$165.96	$165.96	$512.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $281.84 / $416.87	Professional		$223.87	$281.84	$416.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $208.93 / $316.23	Facility		$83.18	$208.93	$316.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $331.13	Professional		$165.96	$165.96	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $194.98 / $354.81	Facility		$100.00	$194.98	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $147.91 / $194.98	Professional		$120.23	$147.91	$194.98