Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $134.90 / $162.18	Professional		$128.82	$134.90	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $181.97	Professional		$162.18	$162.18	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $165.96 / $245.47	Professional		$44.67	$165.96	$245.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $162.18 / $281.84	Facility		$128.82	$162.18	$281.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $162.18	Professional		$125.89	$162.18	$162.18