Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $442.67 / $1,758.00 / $3,747.02	Facility		$442.67	$1,758.00	$3,747.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $461.47 / $2,537.92 / $3,747.02	Professional		$461.47	$2,537.92	$3,747.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $503.04 / $503.04 / $523.16	Professional		$503.04	$503.04	$523.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,755.00 / $8,584.00 / $11,253.00	Facility		$4,755.00	$8,584.00	$11,253.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $360.87 / $1,796.99 / $3,049.72	Professional		$360.87	$1,796.99	$3,049.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $412.31 / $563.40 / $649.92	Facility		$412.31	$563.40	$649.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $441.17 / $599.48 / $4,387.29	Professional		$441.17	$599.48	$4,387.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $740.47 / $740.47 / $740.47	Facility		$740.47	$740.47	$740.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $545.77 / $2,393.71 / $5,367.06	Professional		$545.77	$2,393.71	$5,367.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $1,168.00 / $6,186.00 / $33,259.00	Facility		$1,168.00	$6,186.00	$33,259.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,768.22 / $4,251.21 / $6,424.51	Professional		$2,768.22	$4,251.21	$6,424.51