Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.88 / $206.16 / $961.78	Professional		$153.88	$206.16	$961.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.26 / $24.34 / $31.64	Professional		$18.26	$24.34	$31.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.05 / $204.05 / $204.05	Facility		$204.05	$204.05	$204.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.05 / $204.05 / $244.85	Professional		$204.05	$204.05	$244.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.65 / $75.00 / $402.49	Professional		$30.65	$75.00	$402.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $133.15 / $183.57 / $258.42	Facility		$133.15	$183.57	$258.42
Providence Facility/Professional Professional Modifier Low / Median / High Price $204.05 / $204.05 / $244.85	Professional		$204.05	$204.05	$244.85
United Facility/Professional Facility Modifier Low / Median / High Price $22.00 / $165.00 / $219.99	Facility		$22.00	$165.00	$219.99
United Facility/Professional Professional Modifier Low / Median / High Price $158.15 / $192.20 / $310.67	Professional		$158.15	$192.20	$310.67