Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.76 / $161.66 / $1,075.00	Facility		$30.76	$161.66	$1,075.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $12.50 / $29.42 / $53.02	Facility	52	$12.50	$29.42	$53.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.20 / $58.84 / $110.14	Professional		$25.20	$58.84	$110.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.50 / $29.42 / $36.21	Professional	52	$12.50	$29.42	$36.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.04 / $23.04 / $23.04	Professional		$23.04	$23.04	$23.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,013.00 / $8,584.00 / $11,253.00	Facility		$3,013.00	$8,584.00	$11,253.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.89 / $55.73 / $91.60	Professional		$24.89	$55.73	$91.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.04 / $32.26 / $38.02	Facility		$23.04	$32.26	$38.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.95 / $62.71 / $79.06	Professional		$29.95	$62.71	$79.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.39 / $42.39 / $87.89	Facility		$42.39	$42.39	$87.89
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $33.90 / $33.90 / $33.90	Facility	52	$33.90	$33.90	$33.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.34 / $74.76 / $133.32	Professional		$33.34	$74.76	$133.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $597.00 / $3,176.00	Facility		$50.00	$597.00	$3,176.00
United Facility/Professional Professional Modifier Low / Median / High Price $61.06 / $96.53 / $119.75	Professional		$61.06	$96.53	$119.75