Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.13 / $219.60 / $5,320.00	Facility		$137.13	$219.60	$5,320.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.38 / $174.09 / $219.60	Professional		$138.38	$174.09	$219.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.00 / $2,316.00 / $4,066.00	Facility		$1,258.00	$2,316.00	$4,066.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.75 / $125.57 / $201.76	Professional		$103.75	$125.57	$201.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $154.31 / $217.71 / $251.14	Facility		$154.31	$217.71	$251.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $171.06 / $219.27 / $349.90	Professional		$171.06	$219.27	$349.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.93 / $286.14 / $286.14	Facility		$109.93	$286.14	$286.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.47 / $224.90 / $345.94	Professional		$157.47	$224.90	$345.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $254.90	Professional		$32.34	$32.34	$254.90
United Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $668.00 / $3,176.00	Facility		$50.00	$668.00	$3,176.00
United Facility/Professional Professional Modifier Low / Median / High Price $162.13 / $223.20 / $365.15	Professional		$162.13	$223.20	$365.15