Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,096.48 / $1,778.28	Facility		$776.25	$1,096.48	$1,778.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $776.25 / $1,230.27	Professional		$741.31	$776.25	$1,230.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $870.96 / $1,513.56	Professional		$776.25	$870.96	$1,513.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $912.01 / $1,479.11	Facility		$870.96	$912.01	$1,479.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $776.25	Professional		$776.25	$776.25	$776.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $1,174.90	Facility		$741.31	$741.31	$1,174.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $741.31 / $1,023.29	Professional		$741.31	$741.31	$1,023.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $776.25 / $1,148.15 / $1,148.15	Facility		$776.25	$1,148.15	$1,148.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $3,090.30	Professional		$776.25	$776.25	$3,090.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $776.25 / $1,000.00	Professional		$776.25	$776.25	$1,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $831.76 / $870.96	Professional		$776.25	$831.76	$870.96