Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.49 / $102.94 / $175.00	Facility		$101.49	$102.94	$175.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $102.94 / $102.94	Professional		$102.94	$102.94	$102.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.53 / $121.39 / $205.88	Facility		$116.53	$121.39	$205.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.49 / $102.94 / $102.94	Professional		$87.49	$102.94	$102.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $111.78 / $164.70	Facility		$102.94	$111.78	$164.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $113.23 / $158.53	Professional		$102.94	$113.23	$158.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $102.94 / $154.28	Facility		$102.94	$102.94	$154.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.94 / $224.79 / $224.79	Professional		$102.94	$224.79	$224.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Professional		$45.00	$45.00	$45.00
United Facility/Professional Professional Modifier Low / Median / High Price $101.49 / $102.94 / $102.94	Professional		$101.49	$102.94	$102.94