Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.83 / $170.83 / $170.83	Facility		$170.83	$170.83	$170.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.83 / $170.83 / $175.95	Professional		$170.83	$170.83	$175.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $170.83 / $170.83 / $257.39	Facility		$170.83	$170.83	$257.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $170.83 / $170.83 / $175.95	Professional		$170.83	$170.83	$175.95