Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $112.20 / $128.82	Facility		$104.71	$112.20	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $128.82 / $190.55	Professional		$104.71	$128.82	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $181.97	Facility		$158.49	$158.49	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $158.49	Professional		$117.49	$117.49	$158.49
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $147.91 / $251.19	Professional		$54.95	$147.91	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $199.53	Professional		$194.98	$194.98	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $181.97 / $245.47	Facility		$109.65	$181.97	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $120.23 / $181.97	Professional		$104.71	$120.23	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $251.19	Professional		$147.91	$147.91	$251.19