Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $137.93 / $137.93	Facility		$137.93	$137.93	$137.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $139.31 / $175.17	Professional		$137.93	$139.31	$175.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $137.93 / $137.93	Facility		$137.93	$137.93	$137.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $137.93	Professional		$137.93	$137.93	$137.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $116.26 / $208.77	Professional		$70.00	$116.26	$208.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $137.93 / $154.58	Facility		$137.93	$137.93	$154.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $193.23	Professional		$137.93	$137.93	$193.23
United Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $137.93	Professional		$137.93	$137.93	$137.93