Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.08 / $1,643.84 / $2,024.91	Professional		$302.08	$1,643.84	$2,024.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $563.66 / $563.66 / $563.66	Facility		$563.66	$563.66	$563.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.04 / $563.66 / $2,795.15	Professional		$441.04	$563.66	$2,795.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $563.66 / $563.66 / $563.66	Facility		$563.66	$563.66	$563.66
Providence Facility/Professional Professional Modifier Low / Median / High Price $374.68 / $1,722.50 / $3,426.96	Professional		$374.68	$1,722.50	$3,426.96
United Facility/Professional Professional Modifier Low / Median / High Price $2,573.25 / $3,230.26 / $5,041.24	Professional		$2,573.25	$3,230.26	$5,041.24