Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $398.11 / $3,890.45	Facility		$141.25	$398.11	$3,890.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $213.80 / $575.44	Professional		$109.65	$213.80	$575.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $165.96 / $389.05 / $1,949.84	Professional	50	$165.96	$389.05	$1,949.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $165.96 / $426.58	Professional		$87.10	$165.96	$426.58
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $263.03 / $263.03 / $263.03	Professional	50	$263.03	$263.03	$263.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $2,398.83 / $4,365.16	Facility		$1,479.11	$2,398.83	$4,365.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $204.17	Professional		$87.10	$104.71	$204.17
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $128.82 / $158.49 / $309.03	Professional	50	$128.82	$158.49	$309.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $147.91 / $194.98	Facility		$109.65	$147.91	$194.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $181.97	Professional		$107.15	$147.91	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $204.17 / $223.87	Facility		$34.67	$204.17	$223.87
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	22	$245.47	$245.47	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $302.00 / $1,174.90	Professional		$134.90	$302.00	$1,174.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $104.71	Professional		$32.36	$33.11	$104.71
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 $114.82 / $234.42 / $380.19	Professional		$114.82	$234.42	$380.19