Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $107.15	Professional		$97.72	$97.72	$107.15
BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $389.05 / $645.65	Facility		$177.83	$389.05	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $107.15	Professional		$97.72	$97.72	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $229.09	Professional		$102.33	$154.88	$229.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $123.03 / $269.15	Facility		$97.72	$123.03	$269.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $141.25	Professional		$125.89	$125.89	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $165.96	Professional		$100.00	$125.89	$165.96