Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.48 / $2,813.10 / $6,915.00	Facility		$124.48	$2,813.10	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.56 / $131.91 / $245.86	Professional		$86.56	$131.91	$245.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.83 / $203.43 / $217.15	Professional		$169.83	$203.43	$217.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.49 / $2,152.57 / $4,143.39	Facility		$759.49	$2,152.57	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.84 / $158.26 / $269.60	Professional		$98.84	$158.26	$269.60
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $148.26 / $237.40 / $404.40	Professional	50	$148.26	$237.40	$404.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $158.01 / $171.93 / $264.02	Facility		$158.01	$171.93	$264.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.72 / $81.72 / $81.72	Facility		$81.72	$81.72	$81.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.78 / $164.90 / $281.70	Professional		$102.78	$164.90	$281.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.19 / $140.35 / $196.76	Professional		$95.19	$140.35	$196.76
United Facility/Professional Facility Modifier Low / Median / High Price $424.00 / $2,360.00 / $4,066.00	Facility		$424.00	$2,360.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $120.39 / $182.08 / $282.52	Professional		$120.39	$182.08	$282.52