Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.77 / $787.00 / $3,740.00	Facility		$97.77	$787.00	$3,740.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $39.72 / $106.28 / $118.65	Facility	52	$39.72	$106.28	$118.65
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $15.89 / $42.51 / $47.46	Facility	53	$15.89	$42.51	$47.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.80 / $222.46 / $342.99	Professional		$79.80	$222.46	$342.99
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $39.72 / $95.64 / $140.71	Professional	52	$39.72	$95.64	$140.71
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $15.89 / $38.25 / $56.28	Professional	53	$15.89	$38.25	$56.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.21 / $251.21 / $251.21	Professional		$251.21	$251.21	$251.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,066.00 / $2,315.00 / $10,277.00	Facility		$1,066.00	$2,315.00	$10,277.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.71 / $176.80 / $368.12	Professional		$84.71	$176.80	$368.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.09 / $103.74 / $122.27	Facility		$74.09	$103.74	$122.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $96.33 / $222.23 / $280.20	Professional		$96.33	$222.23	$280.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.34 / $136.34 / $199.81	Facility		$136.34	$136.34	$199.81
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $109.07 / $109.07 / $109.07	Facility	52	$109.07	$109.07	$109.07
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $27.27 / $27.27 / $27.27	Facility	53	$27.27	$27.27	$27.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.17 / $216.46 / $392.45	Professional		$117.17	$216.46	$392.45
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 $391.00 / $1,334.94 / $3,394.00	Facility		$391.00	$1,334.94	$3,394.00
United Facility/Professional Professional Modifier Low / Median / High Price $195.07 / $278.67 / $387.21	Professional		$195.07	$278.67	$387.21