Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.54 / $395.51 / $8,229.00	Facility		$216.54	$395.51	$8,229.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.54 / $386.68 / $431.05	Professional		$216.54	$386.68	$431.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,496.00 / $10,683.00 / $11,870.00	Facility		$9,496.00	$10,683.00	$11,870.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.37 / $132.19 / $152.51	Professional		$112.37	$132.19	$152.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $523.46 / $7,573.50 / $45,499.55	Facility		$523.46	$7,573.50	$45,499.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $519.75 / $6,674.15 / $11,694.38	Professional		$519.75	$6,674.15	$11,694.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Professional		$45.00	$45.00	$45.00
United Facility/Professional Facility Modifier Low / Median / High Price $405.00 / $2,513.00 / $27,879.00	Facility		$405.00	$2,513.00	$27,879.00
United Facility/Professional Professional Modifier Low / Median / High Price $393.52 / $577.89 / $840.23	Professional		$393.52	$577.89	$840.23