Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $198.26 / $396.51 / $793.02	Facility		$198.26	$396.51	$793.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.26 / $317.20 / $1,699.71	Professional		$198.26	$317.20	$1,699.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,260.81 / $1,525.60 / $81,099.99	Facility		$1,260.81	$1,525.60	$81,099.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.16 / $216.23 / $248.48	Professional		$162.16	$216.23	$248.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.82 / $171.82 / $171.82	Facility		$171.82	$171.82	$171.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.89 / $294.41 / $439.07	Professional		$236.89	$294.41	$439.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $409.73 / $430.87 / $430.87	Professional		$409.73	$430.87	$430.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $242.93 / $271.62 / $345.70	Facility		$242.93	$271.62	$345.70
Providence Facility/Professional Professional Modifier Low / Median / High Price $252.46 / $317.95 / $384.99	Professional		$252.46	$317.95	$384.99
United Facility/Professional Professional Modifier Low / Median / High Price $147.43 / $158.60 / $396.51	Professional		$147.43	$158.60	$396.51