Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.59 / $85.49 / $124.33	Professional		$47.59	$85.49	$124.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.72 / $126.72 / $150.63	Facility		$126.72	$126.72	$150.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.72 / $126.72 / $126.72	Professional		$126.72	$126.72	$126.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $64.05 / $89.47 / $126.72	Facility		$64.05	$89.47	$126.72
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.17 / $126.72 / $178.29	Professional		$109.17	$126.72	$178.29
United Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $86.98 / $222.93	Professional		$86.29	$86.98	$222.93