Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.72 / $222.93 / $3,740.00	Facility		$63.72	$222.93	$3,740.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.81 / $117.52 / $202.82	Professional		$69.81	$117.52	$202.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,013.00 / $8,584.00 / $11,253.00	Facility		$3,013.00	$8,584.00	$11,253.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.83 / $88.26 / $132.51	Professional		$72.83	$88.26	$132.51
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $109.25 / $132.38 / $198.77	Professional	50	$109.25	$132.38	$198.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.01 / $101.75 / $127.19	Facility		$71.01	$101.75	$127.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.90 / $105.39 / $206.05	Professional		$78.90	$105.39	$206.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $133.72 / $133.72 / $133.72	Facility		$133.72	$133.72	$133.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.66 / $170.74 / $278.69	Professional		$98.66	$170.74	$278.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $55.34 / $131.75	Professional		$32.34	$55.34	$131.75
United Facility/Professional Facility Modifier Low / Median / High Price $391.00 / $950.00 / $3,394.00	Facility		$391.00	$950.00	$3,394.00
United Facility/Professional Professional Modifier Low / Median / High Price $126.55 / $184.17 / $264.85	Professional		$126.55	$184.17	$264.85