Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $141.25 / $208.93	Facility		$104.71	$141.25	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $208.93	Professional		$104.71	$104.71	$208.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $123.03 / $199.53	Facility		$117.49	$123.03	$199.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $173.78	Facility		$109.65	$109.65	$173.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $114.82 / $151.36	Professional		$109.65	$114.82	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $229.09 / $229.09	Facility		$104.71	$229.09	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $457.09	Professional		$104.71	$104.71	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $107.15 / $134.90	Professional		$104.71	$107.15	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $125.89	Professional		$104.71	$109.65	$125.89