Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.47 / $202.02 / $202.02	Facility		$129.47	$202.02	$202.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $164.44 / $320.70	Professional		$129.47	$164.44	$320.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.47 / $129.47 / $129.47	Facility		$129.47	$129.47	$129.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $129.47 / $129.47	Professional		$129.47	$129.47	$129.47
Providence Facility/Professional Facility Modifier Low / Median / High Price $128.54 / $129.47 / $129.47	Facility		$128.54	$129.47	$129.47
Providence Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $129.47 / $129.47	Professional		$129.47	$129.47	$129.47
United Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $129.47 / $129.47	Professional		$129.47	$129.47	$129.47