Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.81 / $1,241.00 / $4,437.56	Facility		$163.81	$1,241.00	$4,437.56
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $79.06 / $105.35 / $196.17	Facility	52	$79.06	$105.35	$196.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.13 / $252.16 / $512.79	Professional		$158.13	$252.16	$512.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.52 / $185.73 / $212.20	Professional		$98.52	$185.73	$212.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,421.00 / $2,654.00 / $4,487.00	Facility		$1,421.00	$2,654.00	$4,487.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.72 / $211.97 / $486.53	Professional		$158.72	$211.97	$486.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.57 / $201.21 / $242.51	Facility		$151.57	$201.21	$242.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $212.20 / $410.17 / $535.01	Professional		$212.20	$410.17	$535.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $278.89 / $278.89 / $278.89	Facility		$278.89	$278.89	$278.89
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $223.11 / $223.11 / $223.11	Facility	52	$223.11	$223.11	$223.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.48 / $304.24 / $638.92	Professional		$173.48	$304.24	$638.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $392.34	Professional		$32.34	$32.34	$392.34
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 $225.50 / $353.24 / $712.42	Professional		$225.50	$353.24	$712.42