Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.06 / $416.00 / $8,229.00	Facility		$87.06	$416.00	$8,229.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $41.25 / $78.34 / $185.75	Facility	52	$41.25	$78.34	$185.75
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.50 / $31.34 / $74.30	Facility	53	$16.50	$31.34	$74.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.24 / $199.59 / $331.19	Professional		$92.24	$199.59	$331.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,041.00 / $2,067.00 / $2,978.00	Facility		$1,041.00	$2,067.00	$2,978.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.97 / $198.11 / $292.70	Professional		$107.97	$198.11	$292.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.28 / $108.99 / $128.62	Facility		$79.28	$108.99	$128.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.31 / $205.49 / $266.32	Professional		$97.31	$205.49	$266.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.24 / $143.24 / $143.24	Facility		$143.24	$143.24	$143.24
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $114.59 / $114.59 / $114.59	Facility	52	$114.59	$114.59	$114.59
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.65 / $28.65 / $28.65	Facility	53	$28.65	$28.65	$28.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.72 / $249.25 / $436.67	Professional		$116.72	$249.25	$436.67
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 $391.00 / $1,335.00 / $11,156.00	Facility		$391.00	$1,335.00	$11,156.00
United Facility/Professional Professional Modifier Low / Median / High Price $206.44 / $349.74 / $429.11	Professional		$206.44	$349.74	$429.11