Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.61 / $122.43 / $199.07	Professional		$103.61	$122.43	$199.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.65 / $124.65 / $124.65	Professional		$124.65	$124.65	$124.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.24 / $130.44 / $245.89	Professional		$125.24	$130.44	$245.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.16 / $152.16 / $152.16	Facility		$152.16	$152.16	$152.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.98 / $189.83 / $252.58	Professional		$126.98	$189.83	$252.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $210.15	Professional		$32.34	$32.34	$210.15
Providence Facility/Professional Facility Modifier Low / Median / High Price $106.29 / $143.58 / $216.18	Facility		$106.29	$143.58	$216.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.56 / $210.17 / $338.09	Professional		$137.56	$210.17	$338.09
United Facility/Professional Professional Modifier Low / Median / High Price $139.68 / $197.88 / $275.77	Professional		$139.68	$197.88	$275.77