Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $873.92 / $873.92 / $873.92	Facility		$873.92	$873.92	$873.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $873.92 / $873.92 / $873.92	Professional		$873.92	$873.92	$873.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $873.92 / $873.92 / $873.92	Facility		$873.92	$873.92	$873.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $542.42 / $542.42 / $873.92	Professional		$542.42	$542.42	$873.92
United Facility/Professional Professional Modifier Low / Median / High Price $253.13 / $253.13 / $602.70	Professional		$253.13	$253.13	$602.70