Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.74 / $3,857.90 / $6,915.00	Facility		$281.74	$3,857.90	$6,915.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,097.50 / $4,200.00 / $7,071.00	Facility	50	$2,097.50	$4,200.00	$7,071.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.30 / $297.95 / $600.10	Professional		$172.30	$297.95	$600.10
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $230.97 / $333.41 / $1,029.80	Professional	50	$230.97	$333.41	$1,029.80
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $720.20 / $720.20 / $720.20	Professional	50	$720.20	$720.20	$720.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,354.21 / $5,240.56	Facility		$964.00	$2,354.21	$5,240.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.75 / $317.72 / $586.17	Professional		$179.75	$317.72	$586.17
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $256.51 / $470.17 / $857.44	Professional	50	$256.51	$470.17	$857.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $181.02 / $218.73 / $354.09	Facility		$181.02	$218.73	$354.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $316.67 / $319.42 / $555.26	Professional		$316.67	$319.42	$555.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,000.62 / $1,000.62 / $1,000.62	Facility		$1,000.62	$1,000.62	$1,000.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.36 / $358.15 / $616.07	Professional		$210.36	$358.15	$616.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.44 / $284.47 / $493.20	Professional		$173.44	$284.47	$493.20
United Facility/Professional Facility Modifier Low / Median / High Price $607.00 / $3,218.00 / $5,272.00	Facility		$607.00	$3,218.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $259.85 / $403.46 / $657.66	Professional		$259.85	$403.46	$657.66