Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.42 / $107.42 / $107.42	Professional		$107.42	$107.42	$107.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $159.84 / $159.84 / $159.84	Facility		$159.84	$159.84	$159.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.84 / $159.84 / $159.84	Professional		$159.84	$159.84	$159.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $159.84 / $159.84 / $159.84	Facility		$159.84	$159.84	$159.84
Providence Facility/Professional Professional Modifier Low / Median / High Price $98.34 / $147.53 / $224.90	Professional		$98.34	$147.53	$224.90
United Facility/Professional Professional Modifier Low / Median / High Price $129.41 / $129.41 / $129.41	Professional		$129.41	$129.41	$129.41