Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.54 / $592.60 / $2,746.40	Facility		$59.54	$592.60	$2,746.40
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $555.03 / $865.46 / $1,573.70	Facility	50	$555.03	$865.46	$1,573.70
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $18.94 / $26.62 / $39.25	Facility	52	$18.94	$26.62	$39.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.67 / $67.14 / $134.55	Professional		$42.67	$67.14	$134.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $76.56 / $117.45 / $361.25	Professional	50	$76.56	$117.45	$361.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.34 / $70.68 / $82.46	Professional		$52.34	$70.68	$82.46
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $83.52 / $106.02 / $123.69	Professional	50	$83.52	$106.02	$123.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,041.00 / $2,067.00 / $2,978.00	Facility		$1,041.00	$2,067.00	$2,978.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $56.11 / $88.74	Professional		$33.95	$56.11	$88.74
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $50.92 / $84.16 / $133.11	Professional	50	$50.92	$84.16	$133.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.87 / $56.52 / $69.09	Facility		$41.87	$56.52	$69.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.81 / $70.68 / $94.21	Professional		$54.81	$70.68	$94.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.04 / $77.04 / $77.28	Facility		$77.04	$77.04	$77.28
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $61.63 / $61.63 / $61.63	Facility	52	$61.63	$61.63	$61.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $83.57 / $128.15	Professional		$52.92	$83.57	$128.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $76.56	Professional		$32.34	$32.34	$76.56
United Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $668.00 / $3,176.00	Facility		$50.00	$668.00	$3,176.00
United Facility/Professional Professional Modifier Low / Median / High Price $59.20 / $84.77 / $124.26	Professional		$59.20	$84.77	$124.26
United Facility/Professional Professional Modifier 50 Low / Median / High Price $80.00 / $80.00 / $85.00	Professional	50	$80.00	$80.00	$85.00