Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $112.20	Professional		$97.72	$97.72	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $102.33	Professional		$97.72	$97.72	$102.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $102.33	Professional		$50.12	$60.26	$102.33
Providence Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $123.03 / $281.84	Facility		$97.72	$123.03	$281.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $128.82	Professional		$125.89	$125.89	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $234.42	Professional		$93.33	$125.89	$234.42