Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.16 / $527.65 / $5,320.00	Facility		$202.16	$527.65	$5,320.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $95.56 / $206.56 / $229.17	Facility	52	$95.56	$206.56	$229.17
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.22 / $82.62 / $91.67	Facility	53	$38.22	$82.62	$91.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.20 / $413.12 / $751.70	Professional		$195.20	$413.12	$751.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.94 / $117.68 / $274.49	Professional		$81.94	$117.68	$274.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,467.00 / $2,293.00 / $4,389.00	Facility		$1,467.00	$2,293.00	$4,389.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.42 / $250.14 / $361.26	Professional		$206.42	$250.14	$361.26
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 / $443.30 / $588.20	Professional		$257.29	$443.30	$588.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.16 / $338.16 / $338.16	Facility		$338.16	$338.16	$338.16
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 $221.61 / $442.89 / $783.10	Professional		$221.61	$442.89	$783.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $440.57	Professional		$32.34	$32.34	$440.57
United Facility/Professional Facility Modifier Low / Median / High Price $523.00 / $1,476.00 / $4,039.00	Facility		$523.00	$1,476.00	$4,039.00
United Facility/Professional Professional Modifier Low / Median / High Price $378.03 / $541.94 / $824.58	Professional		$378.03	$541.94	$824.58