Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.88 / $2,221.00 / $6,915.00	Facility		$104.88	$2,221.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.71 / $107.60 / $295.13	Professional		$51.71	$107.60	$295.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.31 / $90.44 / $153.76	Professional		$44.31	$90.44	$153.76
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 $62.08 / $112.93 / $210.66	Professional		$62.08	$112.93	$210.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.22 / $66.81 / $73.98	Facility		$49.22	$66.81	$73.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $128.79 / $130.05 / $224.09	Professional		$128.79	$130.05	$224.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.56 / $113.72 / $219.20	Professional		$66.56	$113.72	$219.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.14 / $115.86 / $178.15	Professional		$54.14	$115.86	$178.15
United Facility/Professional Facility Modifier Low / Median / High Price $389.00 / $1,570.00 / $2,665.00	Facility		$389.00	$1,570.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $79.65 / $121.98 / $224.47	Professional		$79.65	$121.98	$224.47