Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $828.00 / $828.00 / $828.00	Professional		$828.00	$828.00	$828.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,508.48 / $77,999.99 / $94,999.99	Facility		$2,508.48	$77,999.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $964.80 / $964.80 / $964.80	Professional		$964.80	$964.80	$964.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,044.00 / $1,044.00 / $1,044.00	Facility		$1,044.00	$1,044.00	$1,044.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,044.00 / $1,044.00 / $1,044.00	Professional		$1,044.00	$1,044.00	$1,044.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,044.00 / $1,044.00 / $1,044.00	Facility		$1,044.00	$1,044.00	$1,044.00
Providence Facility/Professional Professional Modifier Low / Median / High Price $648.00 / $648.00 / $1,044.00	Professional		$648.00	$648.00	$1,044.00
United Facility/Professional Professional Modifier Low / Median / High Price $302.39 / $302.39 / $720.00	Professional		$302.39	$302.39	$720.00