Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $254.44 / $254.44 / $254.44	Facility		$254.44	$254.44	$254.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.84 / $228.49	Professional		$164.25	$164.84	$228.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $207.85 / $528.02 / $860.40	Facility		$207.85	$528.02	$860.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $161.94 / $164.25 / $190.64	Facility		$161.94	$164.25	$190.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $164.25	Professional		$164.25	$164.25	$164.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $152.51 / $160.13 / $248.22	Professional		$152.51	$160.13	$248.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $161.94 / $164.25 / $208.60	Facility		$161.94	$164.25	$208.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $190.64	Professional		$164.25	$164.25	$190.64
United Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $174.11	Professional		$164.25	$164.25	$174.11