Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $321.50 / $1,250.00 / $4,657.60	Facility		$321.50	$1,250.00	$4,657.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $305.25 / $937.92 / $1,502.81	Professional		$305.25	$937.92	$1,502.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $822.59 / $1,069.36 / $1,069.36	Professional		$822.59	$1,069.36	$1,069.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,565.00 / $6,125.00 / $14,034.00	Facility		$3,565.00	$6,125.00	$14,034.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $294.58 / $609.95 / $1,676.78	Professional		$294.58	$609.95	$1,676.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $441.87 / $914.92 / $2,515.17	Professional	50	$441.87	$914.92	$2,515.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $260.52 / $356.13 / $410.82	Facility		$260.52	$356.13	$410.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $248.66 / $407.01 / $1,615.16	Professional		$248.66	$407.01	$1,615.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $468.06 / $468.06 / $468.06	Facility		$468.06	$468.06	$468.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $332.33 / $1,275.32 / $2,633.15	Professional		$332.33	$1,275.32	$2,633.15
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 $739.00 / $3,828.00 / $8,582.00	Facility		$739.00	$3,828.00	$8,582.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,164.41 / $1,953.42 / $2,619.39	Professional		$1,164.41	$1,953.42	$2,619.39