Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $893.15 / $3,369.27 / $10,404.00	Facility		$893.15	$3,369.27	$10,404.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $14,178.60 / $14,178.60 / $14,178.60	Facility	22	$14,178.60	$14,178.60	$14,178.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $893.15 / $1,097.45 / $2,933.84	Professional		$893.15	$1,097.45	$2,933.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $916.63 / $1,233.33 / $1,381.32	Professional		$916.63	$1,233.33	$1,381.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,320.00 / $6,090.00 / $19,582.00	Facility		$2,320.00	$6,090.00	$19,582.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $894.27 / $1,064.96 / $1,465.90	Professional		$894.27	$1,064.96	$1,465.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $986.66 / $1,331.99 / $1,627.99	Facility		$986.66	$1,331.99	$1,627.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $986.66 / $1,282.66 / $1,578.66	Professional		$986.66	$1,282.66	$1,578.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,211.14 / $1,211.14 / $12,571.00	Facility		$1,211.14	$1,211.14	$12,571.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $120.27 / $120.27 / $120.27	Facility	AS	$120.27	$120.27	$120.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,062.00 / $1,455.10 / $2,086.66	Professional		$1,062.00	$1,455.10	$2,086.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,282.66	Professional		$32.34	$32.34	$1,282.66
United Facility/Professional Facility Modifier Low / Median / High Price $973.00 / $4,639.00 / $12,296.00	Facility		$973.00	$4,639.00	$12,296.00
United Facility/Professional Professional Modifier Low / Median / High Price $981.86 / $1,455.12 / $2,070.69	Professional		$981.86	$1,455.12	$2,070.69