Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $189.69 / $189.69 / $189.69	Facility		$189.69	$189.69	$189.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.59 / $189.69 / $312.02	Professional		$143.59	$189.69	$312.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $156.84 / $577.16 / $937.12	Facility		$156.84	$577.16	$937.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $177.04 / $177.04 / $177.04	Facility		$177.04	$177.04	$177.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.04 / $177.04 / $177.04	Professional		$177.04	$177.04	$177.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $106.49 / $106.49 / $106.49	Professional		$106.49	$106.49	$106.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $57.66 / $160.09 / $177.04	Facility		$57.66	$160.09	$177.04
Providence Facility/Professional Professional Modifier Low / Median / High Price $177.04 / $177.04 / $177.04	Professional		$177.04	$177.04	$177.04
United Facility/Professional Professional Modifier Low / Median / High Price $151.63 / $195.02 / $195.02	Professional		$151.63	$195.02	$195.02