Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $109.44	Facility		$109.44	$109.44	$109.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $110.53	Professional		$109.44	$109.44	$110.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $120.71	Professional		$109.44	$109.44	$120.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $153.22 / $175.10	Facility		$109.44	$153.22	$175.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $120.38 / $158.69	Professional		$109.44	$120.38	$158.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $1,417.80 / $1,417.80	Facility		$109.44	$1,417.80	$1,417.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $297.39	Professional		$109.44	$109.44	$297.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $113.81 / $206.48 / $268.42	Professional		$113.81	$206.48	$268.42
United Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $130.11	Professional		$109.44	$109.44	$130.11