Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.68 / $164.68 / $164.68	Facility		$164.68	$164.68	$164.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.46 / $224.80 / $753.79	Professional		$134.46	$224.80	$753.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $159.22 / $159.22 / $159.22	Facility		$159.22	$159.22	$159.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.23 / $159.22 / $159.22	Professional		$116.23	$159.22	$159.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $238.80 / $298.51 / $447.76	Professional		$238.80	$298.51	$447.76
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.11 / $72.11 / $224.34	Facility		$72.11	$72.11	$224.34
Providence Facility/Professional Professional Modifier Low / Median / High Price $116.23 / $159.22 / $281.51	Professional		$116.23	$159.22	$281.51
United Facility/Professional Professional Modifier Low / Median / High Price $103.27 / $111.70 / $168.25	Professional		$103.27	$111.70	$168.25