Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $141.25	Professional		$112.20	$112.20	$141.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $125.89	Professional		$112.20	$112.20	$125.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $165.96 / $354.81	Professional		$44.67	$165.96	$354.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $141.25 / $446.68	Facility		$112.20	$141.25	$446.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $295.12	Professional		$125.89	$125.89	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $812.83	Professional		$125.89	$177.83	$812.83