Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.24 / $90.64 / $90.64	Facility		$83.24	$90.64	$90.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $90.64	Professional		$89.75	$89.75	$90.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $173.22	Facility		$89.75	$89.75	$173.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $127.44	Professional		$89.75	$89.75	$127.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $134.63	Facility		$89.75	$89.75	$134.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $103.21	Professional		$89.75	$89.75	$103.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $89.75 / $89.75	Facility		$89.75	$89.75	$89.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $89.75	Professional		$89.75	$89.75	$89.75
United Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $89.75 / $119.89	Professional		$89.75	$89.75	$119.89