Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.60 / $150.60 / $150.60	Facility		$150.60	$150.60	$150.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.50 / $125.50 / $150.60	Professional		$125.50	$125.50	$150.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $167.73 / $615.03 / $1,002.19	Facility		$167.73	$615.03	$1,002.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.19 / $106.49 / $125.58	Professional		$94.19	$106.49	$125.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.94 / $137.94 / $137.94	Facility		$137.94	$137.94	$137.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.94 / $137.94 / $137.94	Professional		$137.94	$137.94	$137.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $113.89 / $113.89 / $113.89	Professional		$113.89	$113.89	$113.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $58.03 / $106.57 / $137.94	Facility		$58.03	$106.57	$137.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.94 / $137.94 / $137.94	Professional		$137.94	$137.94	$137.94
United Facility/Professional Professional Modifier Low / Median / High Price $147.65 / $147.65 / $177.18	Professional		$147.65	$147.65	$177.18