Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $224.89 / $2,220.30 / $6,772.65	Facility		$224.89	$2,220.30	$6,772.65
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $88.04 / $159.30 / $267.69	Facility	52	$88.04	$159.30	$267.69
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $44.98 / $118.06 / $230.92	Facility	53	$44.98	$118.06	$230.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.17 / $325.77 / $640.89	Professional		$180.17	$325.77	$640.89
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $36.95 / $91.27 / $208.01	Professional	53	$36.95	$91.27	$208.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.72 / $228.06 / $233.12	Professional		$153.72	$228.06	$233.12
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $50.24 / $103.92 / $118.65	Professional	53	$50.24	$103.92	$118.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,220.00 / $2,200.00 / $4,260.00	Facility		$1,220.00	$2,200.00	$4,260.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.35 / $219.57 / $467.53	Professional		$169.35	$219.57	$467.53
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $100.40 / $125.86 / $271.74	Professional	53	$100.40	$125.86	$271.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.83 / $168.93 / $252.92	Facility		$21.83	$168.93	$252.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.41 / $255.71 / $424.18	Professional		$41.41	$255.71	$424.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $310.83 / $310.83 / $360.69	Facility		$310.83	$310.83	$360.69
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 $203.78 / $372.79 / $671.31	Professional		$203.78	$372.79	$671.31
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $71.48 / $133.18 / $223.38	Professional	53	$71.48	$133.18	$223.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $337.53	Professional		$32.34	$32.34	$337.53
United Facility/Professional Facility Modifier Low / Median / High Price $523.00 / $1,476.00 / $3,782.00	Facility		$523.00	$1,476.00	$3,782.00
United Facility/Professional Professional Modifier Low / Median / High Price $305.95 / $455.02 / $653.21	Professional		$305.95	$455.02	$653.21
United Facility/Professional Professional Modifier 53 Low / Median / High Price $100.92 / $152.43 / $252.52	Professional	53	$100.92	$152.43	$252.52