Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $262.12 / $262.12	Facility		$164.59	$262.12	$262.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $171.23 / $445.69	Professional		$164.59	$171.23	$445.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $255.84 / $938.11 / $1,528.64	Facility		$255.84	$938.11	$1,528.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.12 / $167.12 / $225.61	Professional		$167.12	$167.12	$225.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $164.59 / $164.59	Facility		$164.59	$164.59	$164.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $164.59	Professional		$164.59	$164.59	$164.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $164.59 / $164.59 / $167.30	Facility		$164.59	$164.59	$167.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $164.59	Professional		$164.59	$164.59	$164.59
United Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $164.59 / $164.59	Professional		$164.59	$164.59	$164.59