Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $172.22 / $268.05 / $15,062.30	Facility		$172.22	$268.05	$15,062.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $173.93 / $338.66	Professional		$172.22	$173.93	$338.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $129.31 / $450.55 / $772.66	Facility		$129.31	$450.55	$772.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.22 / $172.22 / $172.22	Facility		$172.22	$172.22	$172.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $172.22 / $172.22	Professional		$172.22	$172.22	$172.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.80 / $87.80 / $87.80	Professional		$87.80	$87.80	$87.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $51.49 / $74.97 / $172.22	Facility		$51.49	$74.97	$172.22
Providence Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $172.22 / $172.22	Professional		$172.22	$172.22	$172.22
United Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $172.22 / $172.22	Professional		$172.22	$172.22	$172.22