Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.27 / $305.52 / $3,740.00	Facility		$180.27	$305.52	$3,740.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $127.39 / $157.41 / $214.33	Facility	54	$127.39	$157.41	$214.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $167.15 / $210.43 / $358.12	Professional		$167.15	$210.43	$358.12
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $127.39 / $157.41 / $209.39	Professional	54	$127.39	$157.41	$209.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.57 / $194.05 / $242.56	Professional		$133.57	$194.05	$242.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,013.00 / $8,584.00 / $11,253.00	Facility		$3,013.00	$8,584.00	$11,253.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.81 / $163.87 / $266.00	Professional		$110.81	$163.87	$266.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.81 / $257.58 / $314.83	Facility		$190.81	$257.58	$314.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $201.59 / $257.58 / $314.83	Professional		$201.59	$257.58	$314.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.39 / $351.09 / $351.09	Facility		$281.39	$351.09	$351.09
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $245.76 / $245.76 / $245.76	Facility	54	$245.76	$245.76	$245.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.86 / $278.64 / $417.60	Professional		$200.86	$278.64	$417.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $63.46 / $221.75	Professional		$32.34	$63.46	$221.75
United Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $597.00 / $3,176.00	Facility		$50.00	$597.00	$3,176.00
United Facility/Professional Professional Modifier Low / Median / High Price $184.38 / $276.44 / $399.69	Professional		$184.38	$276.44	$399.69