Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.02 / $2,221.00 / $5,063.00	Facility		$136.02	$2,221.00	$5,063.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $31.26 / $68.01 / $128.34	Facility	52	$31.26	$68.01	$128.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.80 / $144.08 / $340.56	Professional		$65.80	$144.08	$340.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.17 / $299.30 / $418.96	Professional		$103.17	$299.30	$418.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $635.46 / $2,067.41 / $3,851.83	Facility		$635.46	$2,067.41	$3,851.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.31 / $109.18 / $221.57	Professional		$63.31	$109.18	$221.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.64 / $88.97 / $133.15	Facility		$67.64	$88.97	$133.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $129.75 / $168.26 / $181.20	Professional		$129.75	$168.26	$181.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.27 / $110.27 / $640.00	Facility		$110.27	$110.27	$640.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $88.22 / $88.22 / $88.22	Facility	52	$88.22	$88.22	$88.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.92 / $167.60 / $327.16	Professional		$84.92	$167.60	$327.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $80.51 / $171.48 / $412.27	Professional		$80.51	$171.48	$412.27
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $64.31 / $64.31 / $144.29	Professional	52	$64.31	$64.31	$144.29
United Facility/Professional Facility Modifier Low / Median / High Price $426.00 / $2,360.00 / $4,066.00	Facility		$426.00	$2,360.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $126.51 / $204.59 / $331.51	Professional		$126.51	$204.59	$331.51