Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $163.62 / $163.62	Facility		$104.73	$163.62	$163.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $133.01 / $241.04	Professional		$104.73	$133.01	$241.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.30 / $415.43 / $676.94	Facility		$113.30	$415.43	$676.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $104.73 / $104.73	Facility		$104.73	$104.73	$104.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $104.73	Professional		$104.73	$104.73	$104.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.58 / $104.73 / $104.73	Facility		$100.58	$104.73	$104.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $104.73	Professional		$104.73	$104.73	$104.73
United Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $104.73	Professional		$104.73	$104.73	$104.73