Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $663.63 / $663.63 / $663.63	Facility		$663.63	$663.63	$663.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $670.26 / $842.81	Professional		$663.63	$670.26	$842.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $634.83 / $846.44 / $860.97	Professional		$634.83	$846.44	$860.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $663.63 / $663.63 / $663.63	Facility		$663.63	$663.63	$663.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $663.63	Professional		$663.63	$663.63	$663.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $601.24 / $1,172.57	Professional		$70.00	$601.24	$1,172.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $620.77 / $663.63 / $842.81	Facility		$620.77	$663.63	$842.81
Providence Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $1,076.21	Professional		$663.63	$663.63	$1,076.21
United Facility/Professional Professional Modifier Low / Median / High Price $663.63 / $663.63 / $663.63	Professional		$663.63	$663.63	$663.63