Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.82 / $156.16 / $2,747.00	Facility		$55.82	$156.16	$2,747.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.04 / $87.91 / $160.00	Professional		$52.04	$87.91	$160.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,482.80 / $2,482.80 / $2,482.80	Professional	50	$2,482.80	$2,482.80	$2,482.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.88 / $89.88 / $89.88	Professional		$89.88	$89.88	$89.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,041.00 / $2,067.00 / $2,978.00	Facility		$1,041.00	$2,067.00	$2,978.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.79 / $63.85 / $92.43	Professional		$50.79	$63.85	$92.43
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $76.19 / $95.77 / $138.63	Professional	50	$76.19	$95.77	$138.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.28 / $76.09 / $89.81	Facility		$53.28	$76.09	$89.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.80 / $78.15 / $126.13	Professional		$59.80	$78.15	$126.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.02 / $100.02 / $189.51	Facility		$100.02	$100.02	$189.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $136.68 / $263.16	Professional		$72.20	$136.68	$263.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $37.43 / $96.93	Professional		$32.34	$37.43	$96.93
United Facility/Professional Facility Modifier Low / Median / High Price $391.00 / $950.00 / $3,394.00	Facility		$391.00	$950.00	$3,394.00
United Facility/Professional Professional Modifier Low / Median / High Price $99.77 / $168.86 / $226.36	Professional		$99.77	$168.86	$226.36