Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $134.90 / $251.19	Facility		$95.50	$134.90	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $89.13 / $123.03	Professional		$87.10	$89.13	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $173.78	Facility		$87.10	$87.10	$173.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
United Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $87.10 / $87.10	Professional		$85.11	$87.10	$87.10