Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.38 / $787.00 / $5,320.00	Facility		$144.38	$787.00	$5,320.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.38 / $165.39 / $224.48	Professional		$144.38	$165.39	$224.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.00 / $2,257.00 / $4,066.00	Facility		$1,258.00	$2,257.00	$4,066.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.86 / $171.91 / $265.00	Professional		$141.86	$171.91	$265.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $159.21 / $232.02 / $290.02	Facility		$159.21	$232.02	$290.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $165.73 / $224.42 / $331.46	Professional		$165.73	$224.42	$331.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $203.62 / $203.62 / $277.44	Facility		$203.62	$203.62	$277.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.68 / $252.26 / $365.99	Professional		$169.68	$252.26	$365.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $215.45	Professional		$32.34	$32.34	$215.45
United Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $668.00 / $3,176.00	Facility		$50.00	$668.00	$3,176.00
United Facility/Professional Professional Modifier Low / Median / High Price $171.37 / $244.77 / $347.99	Professional		$171.37	$244.77	$347.99