Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $99.13 / $168.52	Facility		$99.13	$99.13	$168.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.12 / $99.13 / $124.90	Professional		$99.12	$99.13	$124.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.22 / $116.90 / $198.26	Facility		$112.22	$116.90	$198.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.26 / $99.13 / $99.13	Professional		$84.26	$99.13	$99.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $109.04 / $158.61	Facility		$99.13	$109.04	$158.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $109.04 / $158.61	Professional		$99.13	$109.04	$158.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.13 / $99.13 / $177.44	Facility		$99.13	$99.13	$177.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $278.80 / $311.62	Professional		$99.13	$278.80	$311.62
United Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $105.08 / $110.35	Professional		$99.13	$105.08	$110.35