Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $269.15 / $3,630.78	Facility		$112.20	$269.15	$3,630.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $281.84	Professional		$81.28	$120.23	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $107.15 / $173.78	Professional		$75.86	$107.15	$173.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $10,715.19 / $11,220.18	Facility		$3,801.89	$10,715.19	$11,220.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $131.83	Professional		$69.18	$87.10	$131.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $112.20 / $131.83	Facility		$87.10	$112.20	$131.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $128.82 / $177.83	Professional		$102.33	$128.82	$177.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $144.54 / $162.18	Facility		$34.67	$144.54	$162.18
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	52	$128.82	$128.82	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $141.25 / $616.60	Professional		$97.72	$141.25	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $602.56 / $3,162.28	Facility		$50.12	$602.56	$3,162.28
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $190.55	Professional		$83.18	$114.82	$190.55