Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $175.40 / $787.00 / $5,520.81	Facility		$175.40	$787.00	$5,520.81
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $84.28 / $112.67 / $183.84	Facility	52	$84.28	$112.67	$183.84
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $33.71 / $45.07 / $73.54	Facility	53	$33.71	$45.07	$73.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.61 / $270.26 / $494.72	Professional		$169.61	$270.26	$494.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.91 / $197.58 / $476.13	Professional		$74.91	$197.58	$476.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,421.00 / $2,542.00 / $4,487.00	Facility		$1,421.00	$2,542.00	$4,487.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $168.93 / $225.61 / $465.17	Professional		$168.93	$225.61	$465.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $164.42 / $225.68 / $260.33	Facility		$164.42	$225.68	$260.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $180.54 / $233.74 / $488.74	Professional		$180.54	$233.74	$488.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $296.61 / $296.61 / $296.61	Facility		$296.61	$296.61	$296.61
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.66 / $307.80 / $620.46	Professional		$183.66	$307.80	$620.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $367.68	Professional		$32.34	$32.34	$367.68
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 $241.01 / $350.54 / $682.93	Professional		$241.01	$350.54	$682.93