Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $80.04 / $80.04	Facility		$80.04	$80.04	$80.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $80.84	Professional		$80.04	$80.04	$80.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $83.24	Professional		$80.04	$80.04	$83.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $112.06 / $128.06	Facility		$80.04	$112.06	$128.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $88.04 / $116.06	Professional		$80.04	$88.04	$116.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.04 / $624.34 / $624.34	Facility		$80.04	$624.34	$624.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $500.65	Professional		$80.04	$80.04	$500.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $83.24	Professional		$45.00	$45.00	$83.24
United Facility/Professional Professional Modifier Low / Median / High Price $80.04 / $80.04 / $85.72	Professional		$80.04	$80.04	$85.72