Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $204.17 / $251.19	Facility		$177.83	$204.17	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $134.90 / $234.42	Professional		$128.82	$134.90	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $524.81 / $891.25	Facility		$245.47	$524.81	$891.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $158.49 / $158.49	Professional		$117.49	$158.49	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Professional		$131.83	$131.83	$131.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $39.81 / $263.03	Facility		$18.62	$39.81	$263.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Professional		$131.83	$131.83	$131.83
United Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $123.03 / $134.90	Facility		$120.23	$123.03	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $141.25 / $141.25	Professional		$131.83	$141.25	$141.25