Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $1,479.11 / $4,466.84	Facility		$199.53	$1,479.11	$4,466.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $245.47 / $660.69	Professional		$112.20	$245.47	$660.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $134.90 / $223.87	Professional		$74.13	$134.90	$223.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,290.87 / $5,248.07	Facility		$1,412.54	$2,290.87	$5,248.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $281.84 / $512.86	Professional		$138.04	$281.84	$512.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $144.54 / $186.21	Facility		$112.20	$144.54	$186.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $302.00 / $398.11	Professional		$158.49	$302.00	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $1,318.26	Facility		$204.17	$204.17	$1,318.26
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	22	$245.47	$245.47	$245.47
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	52	$165.96	$165.96	$165.96
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $41.69 / $41.69 / $41.69	Facility	53	$41.69	$41.69	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $309.03 / $1,318.26	Professional		$138.04	$309.03	$1,318.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,348.96 / $5,248.07	Facility		$524.81	$1,348.96	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $245.47 / $446.68	Professional		$120.23	$245.47	$446.68