Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $851.14 / $3,890.45	Facility		$125.89	$851.14	$3,890.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $138.04 / $251.19	Professional		$104.71	$138.04	$251.19
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $114.82 / $165.96 / $229.09	Professional	54	$114.82	$165.96	$229.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $158.49	Professional		$85.11	$114.82	$158.49
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	54	$79.43	$79.43	$79.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $10,715.19 / $11,220.18	Facility		$3,801.89	$10,715.19	$11,220.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $97.72 / $151.36	Professional		$81.28	$97.72	$151.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $138.04 / $181.97	Facility		$102.33	$138.04	$181.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $151.36 / $186.21	Professional		$123.03	$151.36	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $208.93 / $208.93	Facility		$34.67	$208.93	$208.93
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $144.54 / $144.54 / $144.54	Facility	54	$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $831.76	Professional		$117.49	$177.83	$831.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $56.23	Professional		$32.36	$33.11	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $602.56 / $3,162.28	Facility		$50.12	$602.56	$3,162.28
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.90 / $229.09	Professional		$100.00	$134.90	$229.09