Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.76 / $931.00 / $5,320.00	Facility		$134.76	$931.00	$5,320.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $63.48 / $118.07 / $125.27	Facility	52	$63.48	$118.07	$125.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.96 / $236.13 / $371.90	Professional		$126.96	$236.13	$371.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.56 / $79.63 / $171.51	Professional		$76.56	$79.63	$171.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.00 / $2,565.00 / $5,080.00	Facility		$1,258.00	$2,565.00	$5,080.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.31 / $213.06 / $326.76	Professional		$115.31	$213.06	$326.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $122.51 / $171.51 / $202.14	Facility		$122.51	$171.51	$202.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $159.26 / $254.53 / $327.52	Professional		$159.26	$254.53	$327.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.37 / $225.42 / $225.42	Facility		$186.37	$225.42	$225.42
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $180.34 / $180.34 / $180.34	Facility	52	$180.34	$180.34	$180.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.32 / $274.39 / $580.47	Professional		$156.32	$274.39	$580.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $523.00 / $1,913.00 / $5,301.00	Facility		$523.00	$1,913.00	$5,301.00
United Facility/Professional Professional Modifier Low / Median / High Price $259.07 / $378.92 / $470.01	Professional		$259.07	$378.92	$470.01