Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $152.75 / $350.00 / $5,382.49	Facility		$152.75	$350.00	$5,382.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.78 / $183.43 / $265.20	Professional		$135.78	$183.43	$265.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $191.93 / $191.93 / $191.93	Professional		$191.93	$191.93	$191.93
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 $120.96 / $153.24 / $241.69	Professional		$120.96	$153.24	$241.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $154.54 / $188.16 / $219.68	Facility		$154.54	$188.16	$219.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $151.50 / $217.60 / $401.72	Professional		$151.50	$217.60	$401.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.70 / $278.76 / $1,111.00	Facility		$121.70	$278.76	$1,111.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.69 / $205.89 / $379.12	Professional		$139.69	$205.89	$379.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $261.12	Professional		$32.34	$32.34	$261.12
United Facility/Professional Facility Modifier Low / Median / High Price $523.00 / $1,450.00 / $4,039.00	Facility		$523.00	$1,450.00	$4,039.00
United Facility/Professional Professional Modifier Low / Median / High Price $176.47 / $220.68 / $356.02	Professional		$176.47	$220.68	$356.02