Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.97 / $106.97 / $106.97	Facility		$106.97	$106.97	$106.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $108.04 / $135.85	Professional		$106.97	$108.04	$135.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.97 / $106.97 / $106.97	Facility		$106.97	$106.97	$106.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $106.97	Professional		$106.97	$106.97	$106.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.97 / $37.97 / $61.73	Professional		$37.97	$37.97	$61.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.14 / $106.97 / $117.66	Facility		$100.14	$106.97	$117.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $116.66	Professional		$106.97	$106.97	$116.66
United Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $106.97 / $106.97	Professional		$106.97	$106.97	$106.97