Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $121.37 / $1,201.89 / $5,320.00	Facility		$121.37	$1,201.89	$5,320.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.28 / $1,201.89 / $1,831.81	Professional		$115.28	$1,201.89	$1,831.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,047.61 / $1,047.61 / $1,047.61	Professional		$1,047.61	$1,047.61	$1,047.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,258.00 / $2,316.00 / $4,229.00	Facility		$1,258.00	$2,316.00	$4,229.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.03 / $1,077.21 / $1,582.92	Professional		$99.03	$1,077.21	$1,582.92
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $148.55 / $1,615.81 / $2,328.30	Professional	50	$148.55	$1,615.81	$2,328.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.55 / $154.47 / $178.20	Facility		$112.55	$154.47	$178.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $126.89 / $180.82 / $2,057.00	Professional		$126.89	$180.82	$2,057.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $203.03 / $203.03 / $203.03	Facility		$203.03	$203.03	$203.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.18 / $1,125.93 / $2,832.14	Professional		$139.18	$1,125.93	$2,832.14
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 / $1,450.00 / $5,301.00	Facility		$523.00	$1,450.00	$5,301.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,444.00 / $2,269.04 / $2,864.25	Professional		$1,444.00	$2,269.04	$2,864.25