Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $201.03 / $1,124.03 / $1,124.03	Professional		$201.03	$1,124.03	$1,124.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $253.47 / $297.18 / $996.42	Facility		$253.47	$297.18	$996.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.68 / $253.47 / $253.47	Professional		$82.68	$253.47	$253.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $253.47 / $297.18 / $996.42	Facility		$253.47	$297.18	$996.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $157.33 / $157.33 / $253.47	Professional		$157.33	$157.33	$253.47
United Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $73.42 / $174.81	Professional		$73.42	$73.42	$174.81