Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.05 / $453.27 / $3,740.00	Facility		$112.05	$453.27	$3,740.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $56.03 / $88.43 / $226.64	Facility	52	$56.03	$88.43	$226.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.71 / $176.86 / $578.92	Professional		$113.71	$176.86	$578.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.91 / $136.91 / $136.91	Professional		$136.91	$136.91	$136.91
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 $137.71 / $166.88 / $576.91	Professional		$137.71	$166.88	$576.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.38 / $150.13 / $173.19	Facility		$109.38	$150.13	$173.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.24 / $154.12 / $622.82	Professional		$107.24	$154.12	$622.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $197.32 / $197.32 / $197.32	Facility		$197.32	$197.32	$197.32
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $157.86 / $157.86 / $157.86	Facility	52	$157.86	$157.86	$157.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.66 / $230.21 / $799.95	Professional		$125.66	$230.21	$799.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $453.10	Professional		$32.34	$32.34	$453.10
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 $185.57 / $463.30 / $989.64	Professional		$185.57	$463.30	$989.64