Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,170.39 / $1,170.39 / $2,487.08	Facility		$1,170.39	$1,170.39	$2,487.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,170.39 / $1,170.39 / $1,214.28	Professional		$1,170.39	$1,170.39	$1,214.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,179.25 / $1,228.39 / $3,200.63	Facility		$1,179.25	$1,228.39	$3,200.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $781.25 / $1,041.67 / $1,041.67	Professional		$781.25	$1,041.67	$1,041.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,106.55 / $2,903.31 / $62,999.37	Facility		$2,106.55	$2,903.31	$62,999.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,243.54 / $1,792.17 / $2,661.37	Professional		$1,243.54	$1,792.17	$2,661.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,207.32 / $1,243.54 / $1,243.54	Facility		$1,207.32	$1,243.54	$1,243.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,243.54 / $1,803.88 / $1,803.88	Professional		$1,243.54	$1,803.88	$1,803.88
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 $1,219.16 / $1,219.16 / $1,305.72	Professional		$1,219.16	$1,219.16	$1,305.72