Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $68.48 / $68.48	Facility		$68.48	$68.48	$68.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $69.17 / $86.98	Professional		$68.48	$69.17	$86.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $68.48 / $68.48	Facility		$68.48	$68.48	$68.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $68.48	Professional		$68.48	$68.48	$68.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.94 / $68.48 / $111.64	Professional		$47.94	$68.48	$111.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $68.48 / $79.06	Facility		$60.00	$68.48	$79.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $94.88	Professional		$68.48	$68.48	$94.88
United Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $68.48 / $68.48	Professional		$68.48	$68.48	$68.48