Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,800.00 / $4,800.00 / $26,688.00	Facility		$4,800.00	$4,800.00	$26,688.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,800.00 / $4,800.00 / $4,980.00	Professional		$4,800.00	$4,800.00	$4,980.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,157.35 / $6,721.70 / $6,721.70	Facility		$5,157.35	$6,721.70	$6,721.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $5,130.00 / $5,700.00 / $5,700.00	Professional		$5,130.00	$5,700.00	$5,700.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $5,100.00	Professional		$5,100.00	$5,100.00	$5,100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $5,100.00	Facility		$5,100.00	$5,100.00	$5,100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $7,620.00	Professional		$5,100.00	$5,100.00	$7,620.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $45.00	Professional		$45.00	$45.00	$45.00
United Facility/Professional Professional Modifier Low / Median / High Price $5,000.00 / $5,000.00 / $5,355.00	Professional		$5,000.00	$5,000.00	$5,355.00