Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.35 / $85.35 / $85.35	Facility		$85.35	$85.35	$85.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.35 / $98.63 / $126.47	Professional		$85.35	$98.63	$126.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.74 / $204.39 / $333.05	Facility		$55.74	$204.39	$333.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.25 / $106.80 / $181.30	Professional		$75.25	$106.80	$181.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.27 / $153.35 / $214.63	Professional		$114.27	$153.35	$214.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $162.63	Professional		$32.34	$32.34	$162.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $84.81 / $98.81 / $126.09	Facility		$84.81	$98.81	$126.09
Providence Facility/Professional Professional Modifier Low / Median / High Price $114.27 / $163.93 / $233.50	Professional		$114.27	$163.93	$233.50
United Facility/Professional Professional Modifier Low / Median / High Price $140.69 / $175.46 / $248.05	Professional		$140.69	$175.46	$248.05