Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $902.57 / $902.57 / $902.57	Facility		$902.57	$902.57	$902.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $902.57 / $902.57 / $1,039.42	Professional		$902.57	$902.57	$1,039.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,196.42 / $2,484.86 / $3,221.12	Facility		$1,196.42	$2,484.86	$3,221.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,196.42 / $1,288.45 / $2,208.77	Professional		$1,196.42	$1,288.45	$2,208.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,408.48 / $1,408.48 / $2,432.32	Facility		$1,408.48	$1,408.48	$2,432.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,028.19 / $1,408.48 / $10,194.59	Professional		$1,028.19	$1,408.48	$10,194.59
United Facility/Professional Professional Modifier Low / Median / High Price $860.91 / $1,229.86 / $1,530.46	Professional		$860.91	$1,229.86	$1,530.46