Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $114.82	Facility		$112.20	$112.20	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $190.55	Professional		$97.72	$114.82	$190.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $218.78 / $234.42	Facility		$199.53	$218.78	$234.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $131.83	Professional		$102.33	$125.89	$131.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $295.12 / $380.19	Facility		$162.18	$295.12	$380.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $269.15 / $346.74	Professional		$218.78	$269.15	$346.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $398.11 / $398.11	Facility		$134.90	$398.11	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $204.17 / $1,202.26	Professional		$100.00	$204.17	$1,202.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $186.21	Professional		$112.20	$144.54	$186.21
United Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $117.49 / $144.54	Facility		$85.11	$117.49	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $165.96	Professional		$72.44	$107.15	$165.96