Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $637.00 / $1,277.53 / $8,229.00	Facility		$637.00	$1,277.53	$8,229.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $528.84 / $638.77 / $682.96	Facility	52	$528.84	$638.77	$682.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,057.68 / $1,201.91 / $1,498.19	Professional		$1,057.68	$1,201.91	$1,498.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,643.00 / $3,428.00 / $8,517.00	Facility		$1,643.00	$3,428.00	$8,517.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $982.90 / $1,173.80 / $1,651.22	Professional		$982.90	$1,173.80	$1,651.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,184.61 / $1,442.45 / $1,684.02	Facility		$1,184.61	$1,442.45	$1,684.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,135.26 / $1,625.95 / $2,322.78	Professional		$1,135.26	$1,625.95	$2,322.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,063.20 / $1,429.69 / $1,829.00	Facility		$1,063.20	$1,429.69	$1,829.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,133.07 / $1,133.07 / $1,133.07	Facility	52	$1,133.07	$1,133.07	$1,133.07
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $141.63 / $141.63 / $141.63	Facility	AS	$141.63	$141.63	$141.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,104.65 / $1,412.13 / $2,648.74	Professional		$1,104.65	$1,412.13	$2,648.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,509.81	Professional		$32.34	$32.34	$1,509.81
United Facility/Professional Facility Modifier Low / Median / High Price $739.00 / $2,194.00 / $8,174.00	Facility		$739.00	$2,194.00	$8,174.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,149.68 / $1,383.31 / $2,218.88	Professional		$1,149.68	$1,383.31	$2,218.88