Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $97.72	Professional		$77.62	$77.62	$97.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $89.13	Professional		$77.62	$77.62	$89.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $87.10 / $128.82	Professional		$60.26	$87.10	$128.82
Providence Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $97.72 / $263.03	Facility		$77.62	$97.72	$263.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $125.89 / $125.89	Professional		$117.49	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $83.18 / $125.89	Professional		$77.62	$83.18	$125.89