Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.69 / $90.64 / $90.64	Facility		$57.69	$90.64	$90.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.75 / $90.64 / $94.23	Professional		$89.75	$90.64	$94.23
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 / $208.09	Professional		$89.75	$89.75	$208.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.67 / $1,417.80 / $1,417.80	Facility		$84.67	$1,417.80	$1,417.80
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 $87.06 / $89.75 / $1,667.54	Professional		$87.06	$89.75	$1,667.54