Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $560.75 / $605.16 / $644.03	Professional		$560.75	$605.16	$644.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,192.92 / $3,192.92 / $3,192.92	Facility		$3,192.92	$3,192.92	$3,192.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $555.20 / $3,192.92 / $3,192.92	Professional		$555.20	$3,192.92	$3,192.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $555.20 / $1,384.63 / $3,192.92	Facility		$555.20	$1,384.63	$3,192.92
Providence Facility/Professional Professional Modifier Low / Median / High Price $602.35 / $602.35 / $3,192.92	Professional		$602.35	$602.35	$3,192.92
United Facility/Professional Professional Modifier Low / Median / High Price $555.20 / $555.20 / $555.20	Professional		$555.20	$555.20	$555.20