Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $257.04	Professional		$93.33	$125.89	$257.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $12.88 / $181.97	Professional		$11.22	$12.88	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $112.20 / $112.20	Professional		$15.49	$112.20	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $223.87 / $389.05	Professional		$11.75	$223.87	$389.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $112.20 / $154.88	Facility		$70.79	$112.20	$154.88
Providence Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $95.50 / $112.20	Professional		$15.49	$95.50	$112.20
United Facility/Professional Facility Modifier Low / Median / High Price $9.77 / $97.72 / $134.90	Facility		$9.77	$97.72	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $100.00 / $162.18	Professional		$77.62	$100.00	$162.18