Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $109.44	Facility		$109.44	$109.44	$109.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $110.53 / $138.97	Professional		$109.44	$110.53	$138.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.07 / $153.43 / $374.23	Professional		$115.07	$153.43	$374.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $109.44	Facility		$109.44	$109.44	$109.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $109.44	Professional		$109.44	$109.44	$109.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $206.48 / $336.56 / $336.56	Professional		$206.48	$336.56	$336.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $138.97	Facility		$109.44	$109.44	$138.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $314.81	Professional		$109.44	$109.44	$314.81
United Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $109.44	Professional		$109.44	$109.44	$109.44