Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.50 / $263.83 / $3,740.00	Facility		$102.50	$263.83	$3,740.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $64.76 / $79.95 / $94.00	Facility	54	$64.76	$79.95	$94.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.35 / $108.26 / $167.64	Professional		$86.35	$108.26	$167.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.85 / $108.87 / $159.52	Professional		$96.85	$108.87	$159.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,066.00 / $2,045.00 / $2,978.00	Facility		$1,066.00	$2,045.00	$2,978.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.59 / $81.94 / $141.74	Professional		$64.59	$81.94	$141.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $96.92 / $130.84 / $146.66	Facility		$96.92	$130.84	$146.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.94 / $135.93 / $193.84	Professional		$113.94	$135.93	$193.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.79 / $178.33 / $178.33	Facility		$112.79	$178.33	$178.33
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $124.83 / $124.83 / $124.83	Facility	54	$124.83	$124.83	$124.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.17 / $120.41 / $204.73	Professional		$94.17	$120.41	$204.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $152.00	Professional		$32.34	$32.34	$152.00
United Facility/Professional Facility Modifier Low / Median / High Price $59.00 / $597.00 / $1,895.00	Facility		$59.00	$597.00	$1,895.00
United Facility/Professional Professional Modifier Low / Median / High Price $91.16 / $114.18 / $192.91	Professional		$91.16	$114.18	$192.91