Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.90 / $108.03 / $163.03	Facility		$95.90	$108.03	$163.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $95.90 / $130.72	Professional		$95.90	$95.90	$130.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.56 / $113.09 / $191.80	Facility		$108.56	$113.09	$191.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $95.90 / $112.11	Professional		$95.90	$95.90	$112.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.90 / $115.08 / $153.44	Facility		$95.90	$115.08	$153.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $105.49 / $147.69	Professional		$95.90	$105.49	$147.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.90 / $280.50 / $280.50	Facility		$95.90	$280.50	$280.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $95.90 / $1,787.06	Professional		$95.90	$95.90	$1,787.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $99.73 / $157.10 / $204.23	Professional		$99.73	$157.10	$204.23
United Facility/Professional Professional Modifier Low / Median / High Price $95.90 / $101.65 / $111.82	Professional		$95.90	$101.65	$111.82