Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $389.05 / $389.05	Facility		$190.55	$389.05	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $288.40 / $426.58	Facility		$190.55	$288.40	$426.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $169.82 / $288.40	Professional		$144.54	$169.82	$288.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $288.40 / $380.19	Facility		$190.55	$288.40	$380.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $436.52	Professional		$190.55	$190.55	$436.52
United Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $323.59 / $323.59	Facility		$269.15	$323.59	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $186.21 / $204.17	Professional		$169.82	$186.21	$204.17