Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $131.90 / $131.90	Facility		$131.90	$131.90	$131.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $133.22 / $167.51	Professional		$131.90	$133.22	$167.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $131.90 / $131.90	Facility		$131.90	$131.90	$131.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $131.90	Professional		$131.90	$131.90	$131.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $155.44 / $155.44 / $233.17	Professional		$155.44	$155.44	$233.17
Providence Facility/Professional Facility Modifier Low / Median / High Price $123.42 / $131.90 / $151.13	Facility		$123.42	$131.90	$151.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $181.37	Professional		$131.90	$131.90	$181.37
United Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $131.90	Professional		$131.90	$131.90	$131.90