Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.03 / $75.48 / $75.48	Facility		$49.03	$75.48	$75.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.03 / $62.27 / $112.48	Professional		$49.03	$62.27	$112.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.01 / $174.24 / $298.81	Facility		$50.01	$174.24	$298.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $49.03 / $49.03 / $49.03	Facility		$49.03	$49.03	$49.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.03 / $49.03 / $49.03	Professional		$49.03	$49.03	$49.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $33.95 / $33.95	Professional		$33.95	$33.95	$33.95
Providence Facility/Professional Facility Modifier Low / Median / High Price $9.98 / $14.61 / $49.03	Facility		$9.98	$14.61	$49.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.03 / $49.03 / $49.03	Professional		$49.03	$49.03	$49.03
United Facility/Professional Professional Modifier Low / Median / High Price $49.03 / $49.03 / $49.03	Professional		$49.03	$49.03	$49.03