Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $263.03 / $562.34	Facility		$169.82	$263.03	$562.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.04 / $162.18	Professional		$100.00	$138.04	$162.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $512.86	Facility		$169.82	$169.82	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $67.61 / $194.98	Professional		$67.61	$67.61	$194.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $169.82 / $169.82	Facility		$134.90	$169.82	$169.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $186.21 / $239.88	Professional		$169.82	$186.21	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $169.82 / $380.19	Facility		$109.65	$169.82	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $154.88 / $309.03	Professional		$89.13	$154.88	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $77.62 / $169.82	Professional		$70.79	$77.62	$169.82