Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $506.18 / $525.40 / $2,849.94	Facility		$506.18	$525.40	$2,849.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $506.18 / $525.40 / $640.73	Professional		$506.18	$525.40	$640.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.00 / $208.00 / $208.00	Facility		$208.00	$208.00	$208.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.80 / $208.00 / $208.00	Professional		$176.80	$208.00	$208.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $640.73 / $1,057.20 / $41,999.58	Facility		$640.73	$1,057.20	$41,999.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $704.80 / $897.02 / $11,885.67	Professional		$704.80	$897.02	$11,885.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $416.47 / $488.94 / $768.88	Facility		$416.47	$488.94	$768.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $668.63 / $835.78 / $3,088.32	Professional		$668.63	$835.78	$3,088.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $269.11 / $384.44 / $704.80	Professional		$269.11	$384.44	$704.80