Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $1,000.00 / $3,890.45	Facility		$77.62	$1,000.00	$3,890.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $194.98 / $436.52	Professional		$72.44	$194.98	$436.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $218.78 / $295.12 / $912.01	Professional	50	$218.78	$295.12	$912.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $104.71 / $128.82 / $338.84	Professional	50	$104.71	$128.82	$338.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,801.89 / $10,715.19 / $11,220.18	Facility		$3,801.89	$10,715.19	$11,220.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $81.28	Professional		$52.48	$63.10	$81.28
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $93.33 / $120.23	Professional	50	$79.43	$93.33	$120.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $102.33 / $131.83	Facility		$74.13	$102.33	$131.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $125.89	Professional		$69.18	$102.33	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $141.25 / $141.25	Facility		$34.67	$141.25	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $263.03 / $1,047.13	Professional		$95.50	$263.03	$1,047.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $158.49	Professional		$32.36	$33.11	$158.49
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $954.99 / $3,388.44	Facility		$389.05	$954.99	$3,388.44
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $169.82 / $331.13	Professional		$81.28	$169.82	$331.13