Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Facility		$57.54	$57.54	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $97.72	Professional		$50.12	$70.79	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $204.17 / $213.80	Professional		$104.71	$204.17	$213.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $70.79 / $97.72	Professional		$53.70	$70.79	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $120.23 / $208.93	Professional		$60.26	$120.23	$208.93
Providence Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $75.86 / $162.18	Facility		$41.69	$75.86	$162.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Professional		$66.07	$66.07	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $239.88 / $380.19	Professional		$177.83	$239.88	$380.19