Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $128.82	Professional		$112.20	$112.20	$128.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $288.40 / $512.86	Facility		$125.89	$288.40	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $186.21	Professional		$112.20	$112.20	$186.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $169.82 / $223.87	Facility		$112.20	$169.82	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $144.54	Professional		$112.20	$112.20	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $812.83	Professional		$125.89	$177.83	$812.83