Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $80.04	Facility		$80.04	$80.04	$80.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.84 / $101.65	Professional		$80.04	$80.84	$101.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $80.04	Facility		$80.04	$80.04	$80.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $80.04	Professional		$80.04	$80.04	$80.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $130.47 / $624.34	Professional		$70.00	$130.47	$624.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $276.45	Facility		$80.04	$80.04	$276.45
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $780.43	Professional		$80.04	$80.04	$780.43
United Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $80.04	Professional		$80.04	$80.04	$80.04