Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $513.41 / $896.00 / $8,229.00	Facility		$513.41	$896.00	$8,229.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $513.41 / $641.76 / $799.22	Professional		$513.41	$641.76	$799.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $627.01 / $627.01 / $627.01	Professional		$627.01	$627.01	$627.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,320.00 / $4,334.00 / $11,433.00	Facility		$2,320.00	$4,334.00	$11,433.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $502.41 / $609.95 / $919.10	Professional		$502.41	$609.95	$919.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $642.64 / $924.01 / $1,065.92	Facility		$642.64	$924.01	$1,065.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $660.01 / $924.01 / $1,320.02	Professional		$660.01	$924.01	$1,320.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $786.98 / $812.04 / $812.04	Facility		$786.98	$812.04	$812.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $655.73 / $833.90 / $1,260.95	Professional		$655.73	$833.90	$1,260.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $858.01	Professional		$32.34	$32.34	$858.01
United Facility/Professional Facility Modifier Low / Median / High Price $842.00 / $4,539.00 / $10,966.00	Facility		$842.00	$4,539.00	$10,966.00
United Facility/Professional Professional Modifier Low / Median / High Price $561.91 / $802.73 / $1,184.95	Professional		$561.91	$802.73	$1,184.95