Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.81 / $77.81 / $77.81	Professional		$77.81	$77.81	$77.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.68 / $115.68 / $115.68	Facility		$115.68	$115.68	$115.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.50 / $79.50 / $115.68	Professional		$79.50	$79.50	$115.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $115.68 / $115.68 / $115.68	Facility		$115.68	$115.68	$115.68
Providence Facility/Professional Professional Modifier Low / Median / High Price $79.50 / $79.50 / $115.68	Professional		$79.50	$79.50	$115.68
United Facility/Professional Professional Modifier Low / Median / High Price $90.69 / $90.69 / $90.69	Professional		$90.69	$90.69	$90.69