Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.48 / $79.48 / $79.48	Facility		$79.48	$79.48	$79.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.73 / $98.26 / $407.00	Professional		$87.73	$98.26	$407.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.55 / $109.55 / $109.55	Professional		$109.55	$109.55	$109.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $235.03 / $796.74 / $1,410.43	Facility		$235.03	$796.74	$1,410.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.11 / $129.47 / $154.28	Professional		$97.11	$129.47	$154.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.73 / $96.73 / $96.73	Facility		$96.73	$96.73	$96.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $96.73 / $96.73	Professional		$70.61	$96.73	$96.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $129.67 / $162.09 / $243.13	Professional		$129.67	$162.09	$243.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $47.05 / $47.05 / $121.81	Facility		$47.05	$47.05	$121.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $96.73 / $189.95	Professional		$70.61	$96.73	$189.95
United Facility/Professional Professional Modifier Low / Median / High Price $66.17 / $72.88 / $109.78	Professional		$66.17	$72.88	$109.78