Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.91 / $24.28 / $3,740.00	Facility		$15.91	$24.28	$3,740.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $19.98 / $26.25	Professional		$14.00	$19.98	$26.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,041.00 / $1,968.00 / $2,894.00	Facility		$1,041.00	$1,968.00	$2,894.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.94 / $21.25 / $28.13	Professional		$13.94	$21.25	$28.13
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $20.91 / $31.87 / $42.19	Professional	50	$20.91	$31.87	$42.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.84 / $19.30 / $22.53	Facility		$15.84	$19.30	$22.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.54 / $22.47 / $44.14	Professional		$15.54	$22.47	$44.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.59 / $28.59 / $28.59	Facility		$28.59	$28.59	$28.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.02 / $24.62 / $52.91	Professional		$16.02	$24.62	$52.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.69 / $32.34 / $32.34	Professional		$28.69	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $597.00 / $1,895.00	Facility		$50.00	$597.00	$1,895.00
United Facility/Professional Professional Modifier Low / Median / High Price $23.20 / $30.53 / $45.60	Professional		$23.20	$30.53	$45.60