Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $874.00 / $874.00 / $874.00	Professional		$874.00	$874.00	$874.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,615.85 / $5,615.85 / $5,615.85	Facility		$5,615.85	$5,615.85	$5,615.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,615.85 / $5,615.85 / $5,615.85	Professional		$5,615.85	$5,615.85	$5,615.85
Providence Facility/Professional Facility Modifier Low / Median / High Price $5,615.85 / $5,615.85 / $5,615.85	Facility		$5,615.85	$5,615.85	$5,615.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $4,647.60 / $4,841.25 / $5,615.85	Professional		$4,647.60	$4,841.25	$5,615.85
United Facility/Professional Professional Modifier Low / Median / High Price $1,626.66 / $1,626.66 / $3,873.00	Professional		$1,626.66	$1,626.66	$3,873.00