Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $256.70 / $2,699.45 / $7,039.40	Facility		$256.70	$2,699.45	$7,039.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $95.71 / $202.53 / $294.77	Facility	52	$95.71	$202.53	$294.77
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.28 / $81.01 / $117.91	Facility	53	$38.28	$81.01	$117.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.69 / $405.06 / $814.82	Professional		$195.69	$405.06	$814.82
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $96.12 / $194.19 / $264.00	Professional	52	$96.12	$194.19	$264.00
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $38.45 / $73.33 / $103.47	Professional	53	$38.45	$73.33	$103.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.78 / $229.73 / $248.10	Professional		$183.78	$229.73	$248.10
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $26.77 / $57.43 / $58.84	Professional	52	$26.77	$57.43	$58.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,248.00 / $2,292.00 / $4,389.00	Facility		$1,248.00	$2,292.00	$4,389.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.20 / $246.24 / $504.14	Professional		$203.20	$246.24	$504.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $183.78 / $244.05 / $294.05	Facility		$183.78	$244.05	$294.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $257.29 / $435.15 / $582.72	Professional		$257.29	$435.15	$582.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.16 / $338.16 / $389.73	Facility		$338.16	$338.16	$389.73
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 $221.46 / $448.36 / $806.00	Professional		$221.46	$448.36	$806.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $432.13	Professional		$32.34	$32.34	$432.13
United Facility/Professional Facility Modifier Low / Median / High Price $523.00 / $1,450.00 / $5,301.00	Facility		$523.00	$1,450.00	$5,301.00
United Facility/Professional Professional Modifier Low / Median / High Price $389.16 / $577.92 / $835.49	Professional		$389.16	$577.92	$835.49