Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $158.91 / $158.91	Facility		$158.91	$158.91	$158.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $160.51	Professional		$158.91	$158.91	$160.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $179.90 / $187.40 / $271.75	Facility		$179.90	$187.40	$271.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $158.91	Professional		$158.91	$158.91	$158.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $158.91 / $158.91 / $254.27	Facility		$158.91	$158.91	$254.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $166.87 / $244.74	Professional		$158.91	$166.87	$244.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.91 / $158.91 / $158.91	Facility		$152.91	$158.91	$158.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.91 / $158.91 / $277.68	Professional		$158.91	$158.91	$277.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $148.76 / $148.76 / $148.76	Professional		$148.76	$148.76	$148.76
United Facility/Professional Professional Modifier Low / Median / High Price $63.57 / $158.91 / $158.91	Professional		$63.57	$158.91	$158.91