Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $131.83	Facility		$87.10	$87.10	$131.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $100.00	Professional		$87.10	$87.10	$100.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $177.83 / $177.83	Facility		$81.28	$177.83	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $363.08	Professional		$87.10	$87.10	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $95.50 / $102.33	Professional		$87.10	$95.50	$102.33