Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.86 / $201.92 / $694.80	Facility		$115.86	$201.92	$694.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.28 / $110.89 / $148.96	Professional		$79.28	$110.89	$148.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.51 / $121.12 / $621.79	Facility		$86.51	$121.12	$621.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.60 / $142.29 / $282.56	Professional		$82.60	$142.29	$282.56
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $45.87 / $99.31 / $141.66	Professional		$45.87	$99.31	$141.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.99 / $71.96 / $208.55	Professional		$69.99	$71.96	$208.55
United Facility/Professional Facility Modifier Low / Median / High Price $165.51 / $165.51 / $165.51	Facility		$165.51	$165.51	$165.51
United Facility/Professional Professional Modifier Low / Median / High Price $57.93 / $69.69 / $259.33	Professional		$57.93	$69.69	$259.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.51 / $165.51 / $165.51	Professional		$165.51	$165.51	$165.51