Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $796.09 / $796.09 / $1,353.35	Facility		$796.09	$796.09	$1,353.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $796.09 / $796.09 / $835.90	Professional		$796.09	$796.09	$835.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $901.24 / $938.79 / $1,361.31	Facility		$901.24	$938.79	$1,361.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $796.09 / $796.09 / $796.09	Professional		$796.09	$796.09	$796.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $796.09 / $837.76 / $1,273.74	Facility		$796.09	$837.76	$1,273.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $796.09 / $835.89 / $1,225.98	Professional		$796.09	$835.89	$1,225.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $796.09 / $796.09 / $806.51	Facility		$796.09	$796.09	$806.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $796.09 / $796.09 / $1,433.72	Professional		$796.09	$796.09	$1,433.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $760.40 / $760.40 / $760.40	Professional		$760.40	$760.40	$760.40
United Facility/Professional Professional Modifier Low / Median / High Price $318.44 / $796.09 / $800.15	Professional		$318.44	$796.09	$800.15