Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $2,754.23 / $6,606.93	Facility		$331.13	$2,754.23	$6,606.93
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $707.95 / $4,570.88 / $4,570.88	Facility	52	$707.95	$4,570.88	$4,570.88
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $89.13 / $165.96 / $281.84	Facility	53	$89.13	$165.96	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $354.81 / $954.99	Professional		$177.83	$354.81	$954.99
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $85.11 / $158.49 / $288.40	Professional	53	$85.11	$158.49	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $194.98 / $346.74	Professional		$151.36	$194.98	$346.74
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $46.77 / $91.20 / $112.20	Professional	53	$46.77	$91.20	$112.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $4,570.88 / $8,317.64	Facility		$1,995.26	$4,570.88	$8,317.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $295.12 / $489.78	Professional		$173.78	$295.12	$489.78
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $77.62 / $125.89 / $213.80	Professional	53	$77.62	$125.89	$213.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $147.91 / $239.88	Facility		$24.55	$147.91	$239.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $151.36 / $436.52	Professional		$41.69	$151.36	$436.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $4,570.88 / $4,570.88	Facility		$660.69	$4,570.88	$4,570.88
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $371.54 / $371.54 / $371.54	Facility	22	$371.54	$371.54	$371.54
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	52	$251.19	$251.19	$251.19
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	53	$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $338.84 / $707.95	Professional		$194.98	$338.84	$707.95
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $125.89 / $223.87 / $302.00	Professional	53	$125.89	$223.87	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $3,715.35 / $6,456.54	Facility		$758.58	$3,715.35	$6,456.54
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $309.03 / $524.81	Professional		$177.83	$309.03	$524.81
United Facility/Professional Professional Modifier 53 Low / Median / High Price $100.00 / $100.00 / $100.00	Professional	53	$100.00	$100.00	$100.00