Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $1,000.00 / $3,890.45	Facility		$616.60	$1,000.00	$3,890.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $724.44 / $1,071.52	Professional		$588.84	$724.44	$1,071.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Professional	50	$1,445.44	$1,445.44	$1,445.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $616.60 / $1,621.81	Professional		$389.05	$616.60	$1,621.81
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Professional	50	$2,290.87	$2,290.87	$2,290.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $2,137.96 / $2,951.21	Facility		$1,148.15	$2,137.96	$2,951.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $524.81 / $954.99	Professional		$446.68	$524.81	$954.99
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $676.08 / $794.33 / $1,412.54	Professional	50	$676.08	$794.33	$1,412.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $660.69 / $776.25	Facility		$537.03	$660.69	$776.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $758.58 / $891.25	Professional		$489.78	$758.58	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,000.00 / $1,659.59	Facility		$676.08	$1,000.00	$1,659.59
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $691.83 / $691.83 / $691.83	Facility	54	$691.83	$691.83	$691.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $812.83 / $3,388.44	Professional		$537.03	$812.83	$3,388.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $257.04	Professional		$32.36	$33.11	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $1,445.44 / $5,248.07	Facility		$524.81	$1,445.44	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $645.65 / $1,122.02	Professional		$512.86	$645.65	$1,122.02