Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.72 / $101.72 / $101.72	Facility		$101.72	$101.72	$101.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $102.73 / $129.18	Professional		$101.72	$102.73	$129.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $101.72 / $101.72 / $101.72	Facility		$101.72	$101.72	$101.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $101.72	Professional		$101.72	$101.72	$101.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $119.88 / $119.88 / $179.82	Professional		$119.88	$119.88	$179.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $94.99 / $101.72 / $111.89	Facility		$94.99	$101.72	$111.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $134.50	Professional		$101.72	$101.72	$134.50
United Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $101.72	Professional		$101.72	$101.72	$101.72