Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $104.73 / $178.04	Facility		$104.73	$104.73	$178.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $104.95	Professional		$104.73	$104.73	$104.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.56 / $123.50 / $209.46	Facility		$118.56	$123.50	$209.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.02 / $104.73 / $104.73	Professional		$89.02	$104.73	$104.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $113.89 / $167.57	Facility		$104.73	$113.89	$167.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $115.20 / $161.28	Professional		$104.73	$115.20	$161.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.73 / $104.73 / $105.92	Facility		$104.73	$104.73	$105.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.03 / $104.73 / $189.06	Professional		$92.03	$104.73	$189.06
United Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $104.73 / $104.95	Professional		$104.73	$104.73	$104.95