Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.15 / $787.00 / $5,320.00	Facility		$92.15	$787.00	$5,320.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.15 / $109.70 / $144.76	Professional		$92.15	$109.70	$144.76
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 $99.74 / $120.22 / $170.15	Professional		$99.74	$120.22	$170.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.13 / $148.75 / $185.94	Facility		$102.13	$148.75	$185.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.25 / $148.75 / $212.50	Professional		$106.25	$148.75	$212.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.16 / $130.16 / $178.90	Facility		$130.16	$130.16	$178.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.93 / $168.12 / $243.14	Professional		$118.93	$168.12	$243.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $138.13	Professional		$32.34	$32.34	$138.13
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 $110.11 / $151.00 / $212.86	Professional		$110.11	$151.00	$212.86