Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $345.81 / $3,016.92 / $6,447.64	Facility		$345.81	$3,016.92	$6,447.64
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $97.69 / $213.57 / $378.02	Facility	52	$97.69	$213.57	$378.02
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $39.07 / $85.43 / $151.21	Facility	53	$39.07	$85.43	$151.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.37 / $383.47 / $608.13	Professional		$195.37	$383.47	$608.13
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $97.69 / $180.09 / $270.25	Professional	52	$97.69	$180.09	$270.25
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $39.07 / $77.68 / $108.10	Professional	53	$39.07	$77.68	$108.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.88 / $205.04 / $437.59	Professional		$163.88	$205.04	$437.59
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $20.14 / $57.43 / $71.20	Professional	52	$20.14	$57.43	$71.20
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $132.38 / $132.38 / $132.38	Professional	53	$132.38	$132.38	$132.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,442.00 / $5,000.00 / $8,240.00	Facility		$1,442.00	$5,000.00	$8,240.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.07 / $358.77 / $509.45	Professional		$239.07	$358.77	$509.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $180.09 / $234.12 / $279.14	Facility		$180.09	$234.12	$279.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $384.68 / $461.62 / $577.02	Professional		$384.68	$461.62	$577.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $538.00 / $5,000.00 / $5,000.00	Facility		$538.00	$5,000.00	$5,000.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.67 / $447.48 / $817.20	Professional		$230.67	$447.48	$817.20
United Facility/Professional Facility Modifier Low / Median / High Price $900.00 / $3,782.00 / $5,402.00	Facility		$900.00	$3,782.00	$5,402.00
United Facility/Professional Professional Modifier Low / Median / High Price $380.86 / $504.86 / $1,077.25	Professional		$380.86	$504.86	$1,077.25