Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.00 / $416.00 / $3,740.00	Facility		$68.00	$416.00	$3,740.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $26.62 / $62.07 / $88.83	Facility	52	$26.62	$62.07	$88.83
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $10.65 / $24.83 / $35.53	Facility	53	$10.65	$24.83	$35.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.65 / $125.80 / $256.99	Professional		$54.65	$125.80	$256.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.26 / $65.00 / $93.90	Professional		$24.26	$65.00	$93.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,041.00 / $2,067.00 / $2,978.00	Facility		$1,041.00	$2,067.00	$2,978.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.05 / $88.11 / $183.12	Professional		$45.05	$88.11	$183.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.00 / $69.31 / $83.20	Facility		$52.00	$69.31	$83.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.80 / $185.73 / $248.71	Professional		$72.80	$185.73	$248.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.68 / $95.68 / $95.68	Facility		$95.68	$95.68	$95.68
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $76.54 / $76.54 / $76.54	Facility	52	$76.54	$76.54	$76.54
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.14 / $19.14 / $19.14	Facility	53	$19.14	$19.14	$19.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.96 / $143.90 / $280.10	Professional		$60.96	$143.90	$280.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $177.65	Professional		$32.34	$32.34	$177.65
United Facility/Professional Facility Modifier Low / Median / High Price $334.00 / $594.00 / $3,394.00	Facility		$334.00	$594.00	$3,394.00
United Facility/Professional Professional Modifier Low / Median / High Price $134.46 / $177.24 / $316.42	Professional		$134.46	$177.24	$316.42