Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $590.40 / $720.00 / $3,202.56	Facility		$590.40	$720.00	$3,202.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $504.00 / $576.00 / $720.00	Professional		$504.00	$576.00	$720.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $228.90 / $648.00 / $756.72	Facility		$228.90	$648.00	$756.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.56 / $228.90 / $228.90	Professional		$194.56	$228.90	$228.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $864.00 / $9,450.00 / $22,732.93	Facility		$864.00	$9,450.00	$22,732.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $828.00 / $1,008.00 / $13,355.59	Professional		$828.00	$1,008.00	$13,355.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $468.00 / $560.23 / $950.04	Facility		$468.00	$560.23	$950.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $835.51 / $3,470.40 / $3,470.40	Professional		$835.51	$3,470.40	$3,470.40
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 $302.39 / $432.00 / $720.00	Professional		$302.39	$432.00	$720.00