Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $89.75	Facility		$89.75	$89.75	$89.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $90.64 / $113.98	Professional		$89.75	$90.64	$113.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $89.75	Facility		$89.75	$89.75	$89.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $89.75	Professional		$89.75	$89.75	$89.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $71.81 / $117.07 / $117.07	Professional		$71.81	$117.07	$117.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $83.80 / $89.75 / $98.72	Facility		$83.80	$89.75	$98.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $86.18 / $89.75 / $89.75	Professional		$86.18	$89.75	$89.75
United Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $89.75	Professional		$89.75	$89.75	$89.75