Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.60 / $219.82 / $219.82	Facility		$141.60	$219.82	$219.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $179.84 / $296.69	Professional		$141.60	$179.84	$296.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $136.63 / $501.01 / $816.39	Facility		$136.63	$501.01	$816.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.60 / $141.60 / $141.60	Facility		$141.60	$141.60	$141.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $141.60	Professional		$141.60	$141.60	$141.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $92.77 / $92.77 / $92.77	Professional		$92.77	$92.77	$92.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $89.17 / $90.94 / $141.60	Facility		$89.17	$90.94	$141.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $141.60	Professional		$141.60	$141.60	$141.60
United Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $141.60 / $141.60	Professional		$141.60	$141.60	$141.60