Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $309.61 / $1,910.00 / $5,320.00	Facility		$309.61	$1,910.00	$5,320.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $121.21 / $213.24 / $334.61	Facility	52	$121.21	$213.24	$334.61
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.48 / $85.29 / $133.84	Facility	53	$48.48	$85.29	$133.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.81 / $436.80 / $818.97	Professional		$247.81	$436.80	$818.97
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $48.74 / $82.64 / $108.94	Professional	53	$48.74	$82.64	$108.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $227.59 / $231.88 / $301.44	Professional		$227.59	$231.88	$301.44
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $225.18 / $225.18 / $225.18	Professional	53	$225.18	$225.18	$225.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,248.00 / $2,293.00 / $4,389.00	Facility		$1,248.00	$2,293.00	$4,389.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $253.77 / $309.38 / $657.75	Professional		$253.77	$309.38	$657.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $231.88 / $307.67 / $371.01	Facility		$231.88	$307.67	$371.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $324.63 / $463.76 / $607.55	Professional		$324.63	$463.76	$607.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.66 / $426.66 / $516.67	Facility		$426.66	$426.66	$516.67
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $341.33 / $341.33 / $341.33	Facility	52	$341.33	$341.33	$341.33
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $85.33 / $85.33 / $85.33	Facility	53	$85.33	$85.33	$85.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.69 / $503.21 / $911.75	Professional		$279.69	$503.21	$911.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $453.27	Professional		$32.34	$32.34	$453.27
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 $411.07 / $623.48 / $875.98	Professional		$411.07	$623.48	$875.98