Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.60 / $182.13 / $680.22	Professional		$137.60	$182.13	$680.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $206.64 / $206.64 / $206.64	Facility		$206.64	$206.64	$206.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.25 / $206.64 / $222.91	Professional		$99.25	$206.64	$222.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.71 / $147.60 / $206.64	Facility		$109.71	$147.60	$206.64
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.90 / $206.51 / $268.10	Professional		$123.90	$206.51	$268.10
United Facility/Professional Professional Modifier Low / Median / High Price $176.72 / $210.56 / $240.64	Professional		$176.72	$210.56	$240.64