Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Facility		$691.83	$691.83	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $602.56 / $691.83	Professional		$575.44	$602.56	$691.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Professional		$616.60	$616.60	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $70.79	Professional		$50.12	$60.26	$70.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $630.96 / $1,047.13	Facility		$190.55	$630.96	$1,047.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $912.01	Professional		$125.89	$125.89	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $724.44 / $724.44	Professional		$125.89	$724.44	$724.44