Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $334.11 / $3,012.72 / $6,400.43	Facility		$334.11	$3,012.72	$6,400.43
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $89.75 / $167.06 / $4,595.04	Facility	52	$89.75	$167.06	$4,595.04
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $45.23 / $107.70 / $200.28	Facility	53	$45.23	$107.70	$200.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.50 / $318.60 / $527.89	Professional		$179.50	$318.60	$527.89
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $37.21 / $89.75 / $203.27	Professional	53	$37.21	$89.75	$203.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.68 / $215.25 / $264.93	Professional		$150.68	$215.25	$264.93
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $37.77 / $86.88 / $124.53	Professional	53	$37.77	$86.88	$124.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,442.00 / $4,398.00 / $6,834.00	Facility		$1,442.00	$4,398.00	$6,834.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.23 / $297.75 / $422.80	Professional		$199.23	$297.75	$422.80
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $70.56 / $91.32 / $166.04	Professional	53	$70.56	$91.32	$166.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.83 / $165.58 / $236.50	Facility		$21.83	$165.58	$236.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.95 / $304.26 / $425.96	Professional		$39.95	$304.26	$425.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $655.97 / $4,602.72 / $4,603.00	Facility		$655.97	$4,602.72	$4,603.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $248.66 / $248.66 / $248.66	Facility	52	$248.66	$248.66	$248.66
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $62.17 / $62.17 / $62.17	Facility	53	$62.17	$62.17	$62.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.03 / $374.36 / $685.42	Professional		$212.03	$374.36	$685.42
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $116.81 / $258.48 / $320.00	Professional	53	$116.81	$258.48	$320.00
United Facility/Professional Facility Modifier Low / Median / High Price $900.00 / $3,441.00 / $5,242.00	Facility		$900.00	$3,441.00	$5,242.00
United Facility/Professional Professional Modifier Low / Median / High Price $294.24 / $407.65 / $657.25	Professional		$294.24	$407.65	$657.25
United Facility/Professional Professional Modifier 53 Low / Median / High Price $75.00 / $267.31 / $428.87	Professional	53	$75.00	$267.31	$428.87