Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.67 / $187.37 / $1,400.00	Facility		$87.67	$187.37	$1,400.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.11 / $128.77 / $251.24	Professional		$91.11	$128.77	$251.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.10 / $99.72 / $145.43	Facility		$83.10	$99.72	$145.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $96.58 / $96.58 / $96.58	Professional		$96.58	$96.58	$96.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $144.44 / $144.44 / $144.44	Facility		$144.44	$144.44	$144.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.67 / $230.56 / $548.07	Professional		$112.67	$230.56	$548.07
United Facility/Professional Professional Modifier Low / Median / High Price $142.03 / $299.48 / $508.48	Professional		$142.03	$299.48	$508.48