Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,386.00 / $3,500.00 / $16,042.00	Facility		$1,386.00	$3,500.00	$16,042.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,150.81 / $2,360.16 / $3,173.12	Professional		$2,150.81	$2,360.16	$3,173.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,800.00 / $19,595.20 / $27,445.62	Facility		$4,800.00	$19,595.20	$27,445.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,684.70 / $1,982.00 / $2,814.44	Professional		$1,684.70	$1,982.00	$2,814.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,246.91 / $2,920.98 / $3,370.37	Facility		$2,246.91	$2,920.98	$3,370.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,246.91 / $2,668.78 / $3,370.37	Professional		$2,246.91	$2,668.78	$3,370.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,769.26 / $2,658.25 / $4,348.10	Professional		$1,769.26	$2,658.25	$4,348.10
United Facility/Professional Facility Modifier Low / Median / High Price $5,058.00 / $12,330.00 / $17,416.00	Facility		$5,058.00	$12,330.00	$17,416.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,633.16 / $2,588.30 / $4,786.32	Professional		$1,633.16	$2,588.30	$4,786.32