Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $3,019.95 / $6,760.83	Facility		$295.12	$3,019.95	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $426.58 / $912.01	Professional		$194.98	$426.58	$912.01
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $181.97 / $269.15 / $1,000.00	Professional	52	$181.97	$269.15	$1,000.00
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $102.33 / $144.54 / $489.78	Professional	53	$102.33	$144.54	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $389.05	Professional		$162.18	$218.78	$389.05
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $22.91 / $50.12 / $57.54	Professional	52	$22.91	$50.12	$57.54
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $151.36 / $158.49 / $218.78	Professional	53	$151.36	$158.49	$218.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $7,244.36 / $10,471.29	Facility		$2,041.74	$7,244.36	$10,471.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $354.81 / $562.34	Professional		$208.93	$354.81	$562.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $239.88 / $288.40	Facility		$186.21	$239.88	$288.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $478.63 / $602.56	Professional		$398.11	$478.63	$602.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $630.96 / $5,011.87	Facility		$269.15	$630.96	$5,011.87
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $407.38 / $407.38 / $407.38	Facility	22	$407.38	$407.38	$407.38
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	52	$269.15	$269.15	$269.15
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	53	$67.61	$67.61	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $407.38 / $794.33	Professional		$213.80	$407.38	$794.33
United Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $3,801.89 / $6,456.54	Facility		$977.24	$3,801.89	$6,456.54
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $380.19 / $630.96	Professional		$194.98	$380.19	$630.96