Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.65 / $1,976.00 / $6,465.42	Facility		$113.65	$1,976.00	$6,465.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $110.55 / $267.26	Professional		$60.00	$110.55	$267.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.48 / $158.02 / $198.27	Professional		$58.48	$158.02	$198.27
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 $78.58 / $139.41 / $233.93	Professional		$78.58	$139.41	$233.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.87 / $88.20 / $97.65	Facility		$64.87	$88.20	$97.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $131.47 / $132.76 / $232.60	Professional		$131.47	$132.76	$232.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.54 / $73.54 / $73.54	Facility		$73.54	$73.54	$73.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.31 / $141.81 / $244.76	Professional		$82.31	$141.81	$244.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.36 / $117.47 / $160.19	Professional		$71.36	$117.47	$160.19
United Facility/Professional Facility Modifier Low / Median / High Price $212.00 / $1,550.00 / $2,665.00	Facility		$212.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $96.67 / $133.84 / $234.69	Professional		$96.67	$133.84	$234.69