Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $1,096.48	Facility		$549.54	$549.54	$1,096.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $794.33	Professional		$549.54	$549.54	$794.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $645.65 / $1,047.13	Facility		$616.60	$645.65	$1,047.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $912.01	Facility		$575.44	$575.44	$912.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $602.56 / $831.76	Professional		$575.44	$602.56	$831.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $954.99 / $954.99	Facility		$549.54	$954.99	$954.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $2,454.71	Professional		$549.54	$549.54	$2,454.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $562.34 / $707.95	Professional		$549.54	$562.34	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $575.44 / $630.96	Professional		$549.54	$575.44	$630.96