Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.98 / $87.98 / $87.98	Facility		$87.98	$87.98	$87.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $88.86 / $111.73	Professional		$87.98	$88.86	$111.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.98 / $87.98 / $87.98	Facility		$87.98	$87.98	$87.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $87.98	Professional		$87.98	$87.98	$87.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.93 / $154.74 / $154.74	Professional		$94.93	$154.74	$154.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.98 / $87.98 / $111.73	Facility		$87.98	$87.98	$111.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $163.63	Professional		$87.98	$87.98	$163.63
United Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $87.98	Professional		$87.98	$87.98	$87.98