Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $802.87 / $952.04 / $987.30	Facility		$802.87	$952.04	$987.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $817.91 / $952.04 / $989.53	Professional		$817.91	$952.04	$989.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,153.04 / $1,852.28 / $1,946.75	Facility		$1,153.04	$1,852.28	$1,946.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $866.36 / $963.75 / $1,002.36	Professional		$866.36	$963.75	$1,002.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,389.21 / $2,579.25 / $2,966.91	Facility		$1,389.21	$2,579.25	$2,966.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,759.67 / $2,302.90 / $3,056.26	Professional		$1,759.67	$2,302.90	$3,056.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,191.78 / $1,191.78 / $2,170.64	Facility		$1,191.78	$1,191.78	$2,170.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $870.00 / $1,191.78 / $8,835.64	Professional		$870.00	$1,191.78	$8,835.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $616.05 / $919.12 / $1,221.11	Professional		$616.05	$919.12	$1,221.11