Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $111.15	Facility		$111.15	$111.15	$111.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $112.26 / $141.16	Professional		$111.15	$112.26	$141.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $111.15	Facility		$111.15	$111.15	$111.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $111.15	Professional		$111.15	$111.15	$111.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $332.42 / $541.84 / $541.84	Professional		$332.42	$541.84	$541.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $141.16	Facility		$111.15	$111.15	$141.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $440.31	Professional		$111.15	$111.15	$440.31
United Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $111.15	Professional		$111.15	$111.15	$111.15