Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.22 / $493.11 / $3,740.00	Facility		$87.22	$493.11	$3,740.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $34.15 / $76.19 / $133.82	Facility	52	$34.15	$76.19	$133.82
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $13.66 / $30.48 / $53.53	Facility	53	$13.66	$30.48	$53.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.34 / $157.77 / $378.28	Professional		$68.34	$157.77	$378.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.85 / $82.85 / $92.79	Professional		$82.85	$82.85	$92.79
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 $59.10 / $113.16 / $236.53	Professional		$59.10	$113.16	$236.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.28 / $88.22 / $106.05	Facility		$66.28	$88.22	$106.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $92.79 / $279.80 / $364.95	Professional		$92.79	$279.80	$364.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.96 / $121.96 / $121.96	Facility		$121.96	$121.96	$121.96
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $97.57 / $97.57 / $97.57	Facility	52	$97.57	$97.57	$97.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.39 / $24.39 / $24.39	Facility	53	$24.39	$24.39	$24.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.34 / $184.49 / $387.44	Professional		$76.34	$184.49	$387.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $267.63	Professional		$32.34	$32.34	$267.63
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 $182.80 / $254.32 / $496.03	Professional		$182.80	$254.32	$496.03