Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $192.68 / $192.68 / $192.68	Facility		$192.68	$192.68	$192.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.28 / $168.34 / $192.68	Professional		$164.28	$168.34	$192.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $180.98 / $663.60 / $1,081.33	Facility		$180.98	$663.60	$1,081.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.95 / $158.60 / $180.17	Professional		$118.95	$158.60	$180.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.40 / $172.40 / $172.40	Facility		$172.40	$172.40	$172.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.40 / $172.40 / $172.40	Professional		$172.40	$172.40	$172.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $122.88 / $222.62 / $290.38	Professional		$122.88	$222.62	$290.38
Providence Facility/Professional Facility Modifier Low / Median / High Price $143.09 / $172.40 / $181.62	Facility		$143.09	$172.40	$181.62
Providence Facility/Professional Professional Modifier Low / Median / High Price $172.40 / $172.40 / $172.40	Professional		$172.40	$172.40	$172.40
United Facility/Professional Professional Modifier Low / Median / High Price $202.82 / $202.82 / $202.82	Professional		$202.82	$202.82	$202.82