Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.14 / $294.93 / $5,634.00	Facility		$114.14	$294.93	$5,634.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $85.61 / $86.07 / $144.69	Facility	54	$85.61	$86.07	$144.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.96 / $114.76 / $194.74	Professional		$99.96	$114.76	$194.74
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $76.04 / $88.31 / $116.19	Professional	54	$76.04	$88.31	$116.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.91 / $108.45 / $144.24	Professional		$79.91	$108.45	$144.24
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $116.15 / $116.15 / $116.15	Professional	54	$116.15	$116.15	$116.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $856.00 / $4,320.00 / $8,230.00	Facility		$856.00	$4,320.00	$8,230.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.44 / $114.49 / $162.57	Professional		$81.44	$114.49	$162.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.16 / $148.41 / $171.24	Facility		$114.16	$148.41	$171.24
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.16 / $136.99 / $171.24	Professional		$114.16	$136.99	$171.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.51 / $107.51 / $127.44	Facility		$107.51	$107.51	$127.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.43 / $141.91 / $238.70	Professional		$114.43	$141.91	$238.70
United Facility/Professional Facility Modifier Low / Median / High Price $933.00 / $2,252.00 / $4,426.00	Facility		$933.00	$2,252.00	$4,426.00
United Facility/Professional Professional Modifier Low / Median / High Price $98.99 / $128.99 / $242.49	Professional		$98.99	$128.99	$242.49