Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.94 / $78.94 / $132.69	Facility		$78.94	$78.94	$132.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.94 / $132.69 / $132.69	Professional		$78.94	$132.69	$132.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $76.87 / $101.10 / $151.94	Facility		$76.87	$101.10	$151.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $78.94 / $132.69 / $132.69	Professional		$78.94	$132.69	$132.69
United Facility/Professional Professional Modifier Low / Median / High Price $49.25 / $62.49 / $104.15	Professional		$49.25	$62.49	$104.15