Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.77 / $151.75 / $4,846.00	Facility		$79.77	$151.75	$4,846.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.77 / $119.09 / $168.61	Professional		$79.77	$119.09	$168.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $192.17 / $192.17 / $192.17	Professional		$192.17	$192.17	$192.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $856.00 / $4,320.00 / $8,230.00	Facility		$856.00	$4,320.00	$8,230.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.38 / $129.51 / $185.38	Professional		$89.38	$129.51	$185.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.64 / $113.09 / $223.84	Facility		$77.64	$113.09	$223.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $162.44 / $194.93 / $235.04	Professional		$162.44	$194.93	$235.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $153.02 / $153.02 / $153.02	Facility		$153.02	$153.02	$153.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.87 / $145.72 / $247.43	Professional		$95.87	$145.72	$247.43
United Facility/Professional Facility Modifier Low / Median / High Price $933.00 / $2,252.00 / $4,426.00	Facility		$933.00	$2,252.00	$4,426.00
United Facility/Professional Professional Modifier Low / Median / High Price $123.62 / $176.13 / $289.33	Professional		$123.62	$176.13	$289.33