Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $1,737.80 / $5,495.41	Facility		$165.96	$1,737.80	$5,495.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $1,258.93 / $2,290.87	Professional		$123.03	$1,258.93	$2,290.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,148.15 / $1,348.96	Professional		$933.25	$1,148.15	$1,348.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $2,398.83 / $4,365.16	Facility		$1,513.56	$2,398.83	$4,365.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $1,071.52 / $1,584.89	Professional		$100.00	$1,071.52	$1,584.89
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $1,621.81 / $2,398.83	Professional	50	$147.91	$1,621.81	$2,398.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $151.36 / $177.83	Facility		$104.71	$151.36	$177.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $154.88 / $181.97	Professional		$100.00	$154.88	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $204.17 / $204.17	Facility		$34.67	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $1,905.46 / $5,754.40	Professional		$144.54	$1,905.46	$5,754.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,445.44 / $5,248.07	Facility		$524.81	$1,445.44	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $1,000.00 / $2,691.53	Professional		$141.25	$1,000.00	$2,691.53