Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.72 / $69.72 / $69.72	Professional		$69.72	$69.72	$69.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $105.16 / $162.59 / $414.31	Facility		$105.16	$162.59	$414.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.40 / $71.40 / $105.16	Professional		$71.40	$71.40	$105.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $105.16 / $162.59 / $414.31	Facility		$105.16	$162.59	$414.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $60.17 / $85.24 / $133.31	Professional		$60.17	$85.24	$133.31
United Facility/Professional Professional Modifier Low / Median / High Price $79.80 / $79.80 / $79.80	Professional		$79.80	$79.80	$79.80