Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,217.48 / $1,217.48 / $1,700.00	Facility		$1,217.48	$1,217.48	$1,700.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $608.74 / $608.74 / $608.74	Facility	52	$608.74	$608.74	$608.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,062.39 / $1,217.48 / $1,503.47	Professional		$1,062.39	$1,217.48	$1,503.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,332.70 / $1,491.22 / $1,624.71	Facility		$1,332.70	$1,491.22	$1,624.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,444.19 / $1,444.19 / $1,444.19	Professional		$1,444.19	$1,444.19	$1,444.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,429.69 / $1,429.69 / $1,429.69	Facility		$1,429.69	$1,429.69	$1,429.69
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,133.07 / $1,133.07 / $1,133.07	Facility	52	$1,133.07	$1,133.07	$1,133.07
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $141.63 / $141.63 / $141.63	Facility	AS	$141.63	$141.63	$141.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,196.73 / $1,684.88 / $5,943.30	Professional		$1,196.73	$1,684.88	$5,943.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,104.30 / $1,657.17 / $2,449.39	Professional		$1,104.30	$1,657.17	$2,449.39