Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.30 / $245.30 / $245.30	Facility		$245.30	$245.30	$245.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.30 / $245.30 / $252.66	Professional		$245.30	$245.30	$252.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $277.70 / $289.27 / $289.27	Facility		$277.70	$289.27	$289.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.30 / $245.30 / $248.37	Professional		$245.30	$245.30	$248.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $245.30 / $343.42 / $392.48	Facility		$245.30	$343.42	$392.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $245.30 / $269.83 / $355.69	Professional		$245.30	$269.83	$355.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $245.30 / $274.62 / $274.62	Facility		$245.30	$274.62	$274.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $241.87 / $245.30 / $347.13	Professional		$241.87	$245.30	$347.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $216.23 / $251.54 / $291.91	Professional		$216.23	$251.54	$291.91
United Facility/Professional Professional Modifier Low / Median / High Price $245.30 / $245.30 / $262.72	Professional		$245.30	$245.30	$262.72