Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.28 / $253.98 / $3,740.00	Facility		$133.28	$253.98	$3,740.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.28 / $199.66 / $275.70	Professional		$133.28	$199.66	$275.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.58 / $108.91 / $114.31	Professional		$92.58	$108.91	$114.31
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 / $166.78 / $255.24	Professional		$120.96	$166.78	$255.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $147.47 / $199.08 / $224.60	Facility		$147.47	$199.08	$224.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $184.34 / $241.65 / $348.53	Professional		$184.34	$241.65	$348.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.81 / $271.33 / $1,111.00	Facility		$162.81	$271.33	$1,111.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.16 / $216.21 / $370.19	Professional		$137.16	$216.21	$370.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $283.18	Professional		$32.34	$32.34	$283.18
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 $194.79 / $228.77 / $383.98	Professional		$194.79	$228.77	$383.98