Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.94 / $129.94 / $149.43	Facility		$129.94	$129.94	$149.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.94 / $137.86 / $187.40	Professional		$129.94	$137.86	$187.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $216.49 / $567.73 / $803.71	Facility		$216.49	$567.73	$803.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.12 / $247.17 / $393.59	Professional		$127.12	$247.17	$393.59
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $250.94 / $551.79 / $884.44	Facility		$250.94	$551.79	$884.44
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $117.32 / $134.08 / $330.19	Professional		$117.32	$134.08	$330.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $177.54 / $305.14	Professional		$35.97	$177.54	$305.14
United Facility/Professional Professional Modifier Low / Median / High Price $161.09 / $191.61 / $370.11	Professional		$161.09	$191.61	$370.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $139.56 / $139.56 / $139.56	Professional		$139.56	$139.56	$139.56