Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.81 / $177.85 / $3,740.00	Facility		$60.81	$177.85	$3,740.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $27.67 / $43.55 / $68.15	Facility	52	$27.67	$43.55	$68.15
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $11.07 / $17.42 / $27.26	Facility	53	$11.07	$17.42	$27.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $95.71 / $163.52	Professional		$60.27	$95.71	$163.52
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $27.67 / $41.70 / $48.60	Professional	52	$27.67	$41.70	$48.60
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $11.07 / $16.68 / $19.63	Professional	53	$11.07	$16.68	$19.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.08 / $117.56 / $117.56	Professional		$96.08	$117.56	$117.56
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 $62.21 / $88.18 / $136.72	Professional		$62.21	$88.18	$136.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.66 / $82.12 / $96.79	Facility		$58.66	$82.12	$96.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $76.26 / $103.99 / $131.12	Professional		$76.26	$103.99	$131.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.93 / $107.93 / $126.60	Facility		$107.93	$107.93	$126.60
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $86.34 / $86.34 / $86.34	Facility	52	$86.34	$86.34	$86.34
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.59 / $21.59 / $21.59	Facility	53	$21.59	$21.59	$21.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.42 / $125.50 / $224.18	Professional		$83.42	$125.50	$224.18
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 $89.73 / $144.00 / $192.24	Professional		$89.73	$144.00	$192.24