Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.93 / $151.93 / $151.93	Facility		$151.93	$151.93	$151.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.44 / $145.40 / $167.69	Professional		$136.44	$145.40	$167.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $191.15 / $372.17 / $514.62	Facility		$191.15	$372.17	$514.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $191.15 / $205.85 / $330.82	Professional		$191.15	$205.85	$330.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.78 / $190.78 / $332.68	Facility		$190.78	$190.78	$332.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.27 / $190.78 / $1,394.38	Professional		$139.27	$190.78	$1,394.38
United Facility/Professional Professional Modifier Low / Median / High Price $109.07 / $146.71 / $255.42	Professional		$109.07	$146.71	$255.42