Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $178.47 / $2,618.98	Facility		$112.45	$178.47	$2,618.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $129.58 / $701.55	Professional		$112.45	$129.58	$701.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $222.76 / $816.83 / $1,331.02	Facility		$222.76	$816.83	$1,331.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $135.00 / $174.78	Professional		$129.47	$135.00	$174.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $112.45 / $112.45	Facility		$112.45	$112.45	$112.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $112.45	Professional		$112.45	$112.45	$112.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.25 / $151.25 / $151.25	Professional		$151.25	$151.25	$151.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $112.45 / $123.02 / $193.44	Facility		$112.45	$123.02	$193.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $112.45	Professional		$112.45	$112.45	$112.45
United Facility/Professional Professional Modifier Low / Median / High Price $112.45 / $112.45 / $112.45	Professional		$112.45	$112.45	$112.45