Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $81.19 / $137.51	Professional		$66.95	$81.19	$137.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.22 / $1,113.18 / $11,374.89	Facility		$74.22	$1,113.18	$11,374.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.06 / $1,155.99 / $2,039.99	Professional		$77.06	$1,155.99	$2,039.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $50.00 / $60.00	Professional		$35.00	$50.00	$60.00
United Facility/Professional Professional Modifier Low / Median / High Price $59.77 / $87.55 / $152.36	Professional		$59.77	$87.55	$152.36