Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $406.72 / $511.19 / $511.19	Professional		$406.72	$511.19	$511.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.72 / $75.62 / $93.78	Professional		$56.72	$75.62	$93.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $200.00	Facility		$200.00	$200.00	$200.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $200.00 / $200.00	Professional		$200.00	$200.00	$200.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $99.41 / $149.11 / $1,062.63	Professional		$99.41	$149.11	$1,062.63
Providence Facility/Professional Facility Modifier Low / Median / High Price $328.38 / $429.74 / $675.31	Facility		$328.38	$429.74	$675.31
Providence Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $200.00 / $200.00	Professional		$200.00	$200.00	$200.00
United Facility/Professional Professional Modifier Low / Median / High Price $434.69 / $502.80 / $769.30	Professional		$434.69	$502.80	$769.30