Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.62 / $128.62 / $128.62	Facility		$128.62	$128.62	$128.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.90 / $123.10 / $128.62	Professional		$101.90	$123.10	$128.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $161.83 / $311.20 / $435.70	Facility		$161.83	$311.20	$435.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $144.02 / $174.28 / $246.89	Professional		$144.02	$174.28	$246.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.94 / $142.94 / $260.35	Facility		$142.94	$142.94	$260.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.35 / $142.94 / $1,091.20	Professional		$104.35	$142.94	$1,091.20
United Facility/Professional Professional Modifier Low / Median / High Price $83.63 / $124.21 / $207.01	Professional		$83.63	$124.21	$207.01