Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.58 / $330.82 / $330.82	Facility		$203.58	$330.82	$330.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.58 / $222.71 / $539.41	Professional		$203.58	$222.71	$539.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $217.03 / $756.18 / $1,296.78	Facility		$217.03	$756.18	$1,296.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.54 / $204.54 / $276.13	Professional		$204.54	$204.54	$276.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $203.58 / $203.58 / $203.58	Facility		$203.58	$203.58	$203.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.58 / $203.58 / $203.58	Professional		$203.58	$203.58	$203.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $147.36 / $147.36 / $147.36	Professional		$147.36	$147.36	$147.36
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.23 / $118.73 / $203.58	Facility		$70.23	$118.73	$203.58
Providence Facility/Professional Professional Modifier Low / Median / High Price $203.58 / $203.58 / $203.58	Professional		$203.58	$203.58	$203.58
United Facility/Professional Professional Modifier Low / Median / High Price $203.58 / $203.58 / $203.58	Professional		$203.58	$203.58	$203.58