Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $259.83 / $711.20 / $5,320.00	Facility		$259.83	$711.20	$5,320.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $123.49 / $309.49 / $345.73	Facility	52	$123.49	$309.49	$345.73
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $49.40 / $123.80 / $138.29	Facility	53	$49.40	$123.80	$138.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.06 / $563.69 / $853.64	Professional		$252.06	$563.69	$853.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $219.36 / $307.07 / $325.97	Professional		$219.36	$307.07	$325.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,421.00 / $2,326.00 / $4,389.00	Facility		$1,421.00	$2,326.00	$4,389.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $278.70 / $337.73 / $667.39	Professional		$278.70	$337.73	$667.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $240.94 / $330.69 / $381.48	Facility		$240.94	$330.69	$381.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $230.90 / $340.30 / $845.05	Professional		$230.90	$340.30	$845.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $434.63 / $434.63 / $659.53	Facility		$434.63	$434.63	$659.53
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.14 / $621.46 / $1,142.13	Professional		$285.14	$621.46	$1,142.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $665.12	Professional		$32.34	$32.34	$665.12
United Facility/Professional Facility Modifier Low / Median / High Price $523.00 / $1,339.00 / $5,301.00	Facility		$523.00	$1,339.00	$5,301.00
United Facility/Professional Professional Modifier Low / Median / High Price $593.91 / $795.00 / $1,297.33	Professional		$593.91	$795.00	$1,297.33