Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $97.94 / $97.94	Facility		$97.94	$97.94	$97.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $98.92	Professional		$97.94	$97.94	$98.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $115.50 / $210.54	Facility		$97.94	$115.50	$210.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $97.94	Professional		$97.94	$97.94	$97.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $137.12 / $156.69	Facility		$97.94	$137.12	$156.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $107.73 / $142.01	Professional		$97.94	$107.73	$142.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.94 / $175.44 / $175.44	Facility		$97.94	$175.44	$175.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $147.85	Professional		$97.94	$97.94	$147.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.17 / $140.00 / $189.00	Professional		$100.17	$140.00	$189.00
United Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $111.01	Professional		$97.94	$97.94	$111.01