Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $304.95 / $787.00 / $5,320.00	Facility		$304.95	$787.00	$5,320.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $304.95 / $356.53 / $425.44	Professional		$304.95	$356.53	$425.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.00 / $2,316.00 / $4,389.00	Facility		$1,258.00	$2,316.00	$4,389.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.56 / $252.32 / $415.80	Professional		$169.56	$252.32	$415.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $334.75 / $471.63 / $544.07	Facility		$334.75	$471.63	$544.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $332.69 / $471.63 / $673.76	Professional		$332.69	$471.63	$673.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $386.70 / $425.93 / $425.93	Facility		$386.70	$425.93	$425.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.20 / $431.33 / $611.88	Professional		$297.20	$431.33	$611.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $437.94	Professional		$32.34	$32.34	$437.94
United Facility/Professional Facility Modifier Low / Median / High Price $599.00 / $2,723.00 / $6,295.00	Facility		$599.00	$2,723.00	$6,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $278.81 / $404.51 / $611.88	Professional		$278.81	$404.51	$611.88