Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $655.29 / $655.29 / $655.29	Facility		$655.29	$655.29	$655.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $661.85 / $832.23	Professional		$655.29	$661.85	$832.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $655.29 / $655.29 / $655.29	Facility		$655.29	$655.29	$655.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $655.29	Professional		$655.29	$655.29	$655.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $1,075.90 / $1,537.00	Professional		$70.00	$1,075.90	$1,537.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $655.29 / $655.29 / $832.23	Facility		$655.29	$655.29	$832.23
Providence Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $1,515.58	Professional		$655.29	$655.29	$1,515.58
United Facility/Professional Professional Modifier Low / Median / High Price $655.29 / $655.29 / $655.29	Professional		$655.29	$655.29	$655.29