Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $945.58 / $945.58 / $945.58	Facility		$945.58	$945.58	$945.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $881.14 / $945.58 / $1,017.02	Professional		$881.14	$945.58	$1,017.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,393.05 / $2,692.33 / $3,471.05	Facility		$1,393.05	$2,692.33	$3,471.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,253.43 / $1,500.21 / $2,571.79	Professional		$1,253.43	$1,500.21	$2,571.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,132.82 / $1,132.82 / $2,511.52	Facility		$1,132.82	$1,132.82	$2,511.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $826.96 / $826.96 / $10,104.17	Professional		$826.96	$826.96	$10,104.17
United Facility/Professional Facility Modifier Low / Median / High Price $1,052.80 / $1,052.80 / $1,052.80	Facility		$1,052.80	$1,052.80	$1,052.80
United Facility/Professional Professional Modifier Low / Median / High Price $962.03 / $1,263.43 / $1,603.39	Professional		$962.03	$1,263.43	$1,603.39