Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.23 / $1,820.00 / $6,320.89	Facility		$165.23	$1,820.00	$6,320.89
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $27.58 / $36.94 / $127.53	Facility	53	$27.58	$36.94	$127.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.55 / $321.00 / $635.89	Professional		$140.55	$321.00	$635.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $187.76 / $187.76 / $195.27	Professional		$187.76	$187.76	$195.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,271.00 / $2,292.00 / $4,229.00	Facility		$1,271.00	$2,292.00	$4,229.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.33 / $430.23 / $720.23	Professional		$139.33	$430.23	$720.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $150.21 / $210.29 / $247.85	Facility		$150.21	$210.29	$247.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $195.27 / $490.49 / $632.79	Professional		$195.27	$490.49	$632.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $276.39 / $276.39 / $276.39	Facility		$276.39	$276.39	$276.39
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $55.28 / $55.28 / $55.28	Facility	53	$55.28	$55.28	$55.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.67 / $615.75 / $1,192.29	Professional		$192.67	$615.75	$1,192.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $523.00 / $1,450.00 / $5,301.00	Facility		$523.00	$1,450.00	$5,301.00
United Facility/Professional Professional Modifier Low / Median / High Price $514.71 / $841.98 / $1,147.56	Professional		$514.71	$841.98	$1,147.56