Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,983.07 / $2,058.37 / $11,165.40	Facility		$1,983.07	$2,058.37	$11,165.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,757.15 / $2,008.17 / $2,510.21	Professional		$1,757.15	$2,008.17	$2,510.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,562.61 / $2,259.19 / $2,638.23	Facility		$1,562.61	$2,259.19	$2,638.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,275.00 / $1,500.00 / $1,500.00	Professional		$1,275.00	$1,500.00	$1,500.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,012.25 / $32,946.51 / $63,257.29	Facility		$3,012.25	$32,946.51	$63,257.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,886.74 / $3,514.29 / $46,558.55	Professional		$2,886.74	$3,514.29	$46,558.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,631.64 / $1,953.19 / $3,312.23	Facility		$1,631.64	$1,953.19	$3,312.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,913.24 / $12,099.21 / $12,099.21	Professional		$2,913.24	$12,099.21	$12,099.21
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 $1,086.92 / $1,673.47 / $2,789.12	Professional		$1,086.92	$1,673.47	$2,789.12