Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $72.44 / $134.90	Professional		$57.54	$72.44	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $128.82 / $144.54	Professional		$97.72	$128.82	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $204.17	Professional		$64.57	$64.57	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $234.42 / $354.81	Professional		$190.55	$234.42	$354.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $114.82 / $165.96	Facility		$38.90	$114.82	$165.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $162.18	Professional		$64.57	$64.57	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $91.20 / $165.96	Facility		$46.77	$91.20	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $69.18 / $91.20	Professional		$56.23	$69.18	$91.20