Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $414.50 / $414.50 / $414.50	Facility		$414.50	$414.50	$414.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $414.50 / $565.82 / $2,796.02	Professional		$414.50	$565.82	$2,796.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $644.36 / $644.36 / $644.36	Facility		$644.36	$644.36	$644.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $470.38 / $644.36 / $644.36	Professional		$470.38	$644.36	$644.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $601.10 / $751.38 / $1,127.07	Professional		$601.10	$751.38	$1,127.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $242.00 / $242.00 / $644.36	Facility		$242.00	$242.00	$644.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $470.38 / $644.36 / $912.47	Professional		$470.38	$644.36	$912.47
United Facility/Professional Professional Modifier Low / Median / High Price $346.58 / $429.10 / $564.79	Professional		$346.58	$429.10	$564.79