Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $106.70 / $106.70	Facility		$106.70	$106.70	$106.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $107.77	Professional		$106.70	$106.70	$107.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.79 / $125.83 / $125.83	Facility		$120.79	$125.83	$125.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $106.70	Professional		$106.70	$106.70	$106.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $149.38 / $170.72	Facility		$106.70	$149.38	$170.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $117.37 / $154.72	Professional		$106.70	$117.37	$154.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $479.40 / $479.40	Facility		$106.70	$479.40	$479.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $201.04	Professional		$106.70	$106.70	$201.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.10 / $48.75 / $106.70	Professional		$35.10	$48.75	$106.70
United Facility/Professional Professional Modifier Low / Median / High Price $103.50 / $106.70 / $114.28	Professional		$103.50	$106.70	$114.28