Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $214.70 / $214.70 / $214.70	Facility		$214.70	$214.70	$214.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.03 / $214.70 / $305.91	Professional		$183.03	$214.70	$305.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $263.91 / $263.91 / $263.91	Professional		$263.91	$263.91	$263.91
BCBS Facility/Professional Facility Modifier Low / Median / High Price $728.41 / $2,670.95 / $4,352.28	Facility		$728.41	$2,670.95	$4,352.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.14 / $495.97 / $732.24	Professional		$285.14	$495.97	$732.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.00 / $337.88	Professional		$50.00	$60.00	$337.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $169.33 / $240.50 / $305.91	Facility		$169.33	$240.50	$305.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $280.52 / $366.63 / $521.62	Professional		$280.52	$366.63	$521.62
United Facility/Professional Professional Modifier Low / Median / High Price $247.69 / $342.55 / $592.33	Professional		$247.69	$342.55	$592.33