Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.16 / $151.16 / $204.07	Facility		$151.16	$151.16	$204.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $151.16 / $167.94	Professional		$151.16	$151.16	$167.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $171.13 / $178.26 / $178.26	Facility		$171.13	$178.26	$178.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $151.16 / $153.44	Professional		$151.16	$151.16	$153.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.16 / $211.64 / $241.87	Facility		$151.16	$211.64	$241.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $166.29 / $219.20	Professional		$151.16	$166.29	$219.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.16 / $340.68 / $340.68	Facility		$151.16	$340.68	$340.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.33 / $151.16 / $213.91	Professional		$150.33	$151.16	$213.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $158.33 / $216.23	Professional		$151.16	$158.33	$216.23
United Facility/Professional Professional Modifier Low / Median / High Price $151.16 / $151.16 / $166.76	Professional		$151.16	$151.16	$166.76