Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,894.00 / $1,894.00 / $17,823.00	Facility		$1,894.00	$1,894.00	$17,823.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $126.00 / $126.00	Professional		$126.00	$126.00	$126.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,419.00 / $4,441.52	Facility		$1,139.00	$2,419.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.76 / $170.94 / $293.06	Professional		$147.76	$170.94	$293.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $126.00 / $126.00 / $126.00	Facility		$126.00	$126.00	$126.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $126.00 / $1,449.00 / $2,090.40	Facility		$126.00	$1,449.00	$2,090.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $126.00 / $126.00 / $126.00	Facility		$126.00	$126.00	$126.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,641.00 / $2,202.90	Facility		$1,034.00	$1,641.00	$2,202.90