Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.40 / $67.40 / $67.40	Facility		$67.40	$67.40	$67.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.79 / $103.50 / $402.21	Professional		$62.79	$103.50	$402.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.29 / $675.60 / $1,195.93	Facility		$199.29	$675.60	$1,195.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.34 / $109.79 / $130.82	Professional		$82.34	$109.79	$130.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.37 / $66.37 / $66.37	Facility		$66.37	$66.37	$66.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.45 / $66.37 / $66.37	Professional		$48.45	$66.37	$66.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.95 / $137.44 / $206.16	Professional		$109.95	$137.44	$206.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $33.67 / $33.67 / $103.28	Facility		$33.67	$33.67	$103.28
Providence Facility/Professional Professional Modifier Low / Median / High Price $48.45 / $66.37 / $161.06	Professional		$48.45	$66.37	$161.06
United Facility/Professional Professional Modifier Low / Median / High Price $47.36 / $52.16 / $78.56	Professional		$47.36	$52.16	$78.56