Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.62 / $364.51 / $3,740.00	Facility		$86.62	$364.51	$3,740.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $41.77 / $122.00 / $199.94	Facility	52	$41.77	$122.00	$199.94
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.71 / $48.80 / $79.98	Facility	53	$16.71	$48.80	$79.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.04 / $197.39 / $329.10	Professional		$85.04	$197.39	$329.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.26 / $78.26 / $86.77	Professional		$78.26	$78.26	$86.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,041.00 / $2,067.00 / $3,013.00	Facility		$1,041.00	$2,067.00	$3,013.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.96 / $174.51 / $328.69	Professional		$90.96	$174.51	$328.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $81.83 / $112.31 / $129.56	Facility		$81.83	$112.31	$129.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.22 / $115.83 / $334.57	Professional		$80.22	$115.83	$334.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.60 / $147.60 / $147.60	Facility		$147.60	$147.60	$147.60
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.55 / $228.81 / $408.50	Professional		$98.55	$228.81	$408.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $249.57	Professional		$32.34	$32.34	$249.57
United Facility/Professional Facility Modifier Low / Median / High Price $523.00 / $794.00 / $5,301.00	Facility		$523.00	$794.00	$5,301.00
United Facility/Professional Professional Modifier Low / Median / High Price $206.39 / $277.97 / $468.92	Professional		$206.39	$277.97	$468.92