Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $2,290.87 / $6,918.31	Facility		$288.40	$2,290.87	$6,918.31
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,819.70 / $5,370.32 / $18,197.01	Facility	50	$1,819.70	$5,370.32	$18,197.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $323.59 / $776.25	Professional		$151.36	$323.59	$776.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $169.82 / $851.14 / $2,570.40	Professional	50	$169.82	$851.14	$2,570.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $323.59	Professional		$125.89	$177.83	$323.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $218.78 / $275.42 / $426.58	Professional	50	$218.78	$275.42	$426.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $4,073.80 / $15,848.93	Facility		$1,584.89	$4,073.80	$15,848.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $478.63 / $794.33	Professional		$144.54	$478.63	$794.33
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $218.78 / $724.44 / $1,202.26	Professional	50	$218.78	$724.44	$1,202.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $194.98 / $269.15	Facility		$141.25	$194.98	$269.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $346.74 / $478.63	Professional		$177.83	$346.74	$478.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $1,659.59	Facility		$263.03	$263.03	$1,659.59
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $316.23 / $316.23 / $316.23	Facility	22	$316.23	$316.23	$316.23
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	52	$208.93	$208.93	$208.93
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	53	$52.48	$52.48	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $478.63 / $4,897.79	Professional		$173.78	$478.63	$4,897.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $3,388.44 / $6,309.57	Facility		$602.56	$3,388.44	$6,309.57
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $363.08 / $776.25	Professional		$158.49	$363.08	$776.25