Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,172.56	Facility		$1,172.56	$1,172.56	$1,172.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,184.28 / $1,489.15	Professional		$1,172.56	$1,184.28	$1,489.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,172.56	Facility		$1,172.56	$1,172.56	$1,172.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,172.56	Professional		$1,172.56	$1,172.56	$1,172.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,192.50 / $1,943.78 / $1,943.78	Professional		$1,192.50	$1,943.78	$1,943.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,096.63 / $1,172.56 / $1,289.81	Facility		$1,096.63	$1,172.56	$1,289.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,298.50	Professional		$1,172.56	$1,172.56	$1,298.50
United Facility/Professional Professional Modifier Low / Median / High Price $1,172.56 / $1,172.56 / $1,172.56	Professional		$1,172.56	$1,172.56	$1,172.56