Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.94 / $1,521.40 / $3,740.00	Facility		$148.94	$1,521.40	$3,740.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $58.31 / $133.91 / $187.24	Facility	52	$58.31	$133.91	$187.24
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $23.32 / $53.56 / $74.89	Facility	53	$23.32	$53.56	$74.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.97 / $256.77 / $496.20	Professional		$116.97	$256.77	$496.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.73 / $145.82 / $157.04	Professional		$82.73	$145.82	$157.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,066.00 / $2,152.00 / $4,254.00	Facility		$1,066.00	$2,152.00	$4,254.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.79 / $261.41 / $469.30	Professional		$124.79	$261.41	$469.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.17 / $149.03 / $179.47	Facility		$112.17	$149.03	$179.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $157.04 / $288.52 / $376.34	Professional		$157.04	$288.52	$376.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $206.39 / $206.39 / $206.39	Facility		$206.39	$206.39	$206.39
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $165.11 / $165.11 / $165.11	Facility	52	$165.11	$165.11	$165.11
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $41.28 / $41.28 / $41.28	Facility	53	$41.28	$41.28	$41.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.01 / $280.14 / $519.04	Professional		$137.01	$280.14	$519.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $275.98	Professional		$32.34	$32.34	$275.98
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 $244.80 / $358.61 / $540.51	Professional		$244.80	$358.61	$540.51