Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.40 / $167.40 / $167.40	Facility		$167.40	$167.40	$167.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.01 / $130.50 / $167.40	Professional		$115.01	$130.50	$167.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.56 / $29.11 / $62.10	Facility		$21.56	$29.11	$62.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.39 / $34.15 / $49.98	Professional		$19.39	$34.15	$49.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.10 / $147.10 / $234.66	Facility		$147.10	$147.10	$234.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.38 / $125.04 / $147.10	Professional		$107.38	$125.04	$147.10
United Facility/Professional Professional Modifier Low / Median / High Price $12.09 / $21.79 / $105.53	Professional		$12.09	$21.79	$105.53