Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,148.15	Professional		$1,047.13	$1,047.13	$1,148.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Professional		$1,047.13	$1,047.13	$1,047.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $208.93 / $446.68	Professional		$44.67	$208.93	$446.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $1,047.13 / $1,819.70	Facility		$190.55	$1,047.13	$1,819.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $371.54	Professional		$125.89	$125.89	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $302.00 / $1,000.00	Professional		$125.89	$302.00	$1,000.00