Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $111.15 / $111.15	Facility		$111.15	$111.15	$111.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $112.26	Professional		$111.15	$111.15	$112.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $317.64	Professional		$111.15	$111.15	$317.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $155.61 / $177.84	Facility		$111.15	$155.61	$177.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $122.27 / $161.16	Professional		$111.15	$122.27	$161.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.15 / $402.90 / $402.90	Facility		$111.15	$402.90	$402.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $317.25	Professional		$111.15	$111.15	$317.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.59 / $332.42 / $432.15	Professional		$115.59	$332.42	$432.15
United Facility/Professional Professional Modifier Low / Median / High Price $111.15 / $111.15 / $130.26	Professional		$111.15	$111.15	$130.26