Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $176.57 / $2,760.00 / $6,915.00	Facility		$176.57	$2,760.00	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.81 / $171.46 / $293.30	Professional		$95.81	$171.46	$293.30
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $488.82 / $488.82 / $488.82	Professional	50	$488.82	$488.82	$488.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.54 / $169.54 / $233.06	Professional		$169.54	$169.54	$233.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $606.69 / $2,262.42 / $5,084.83	Facility		$606.69	$2,262.42	$5,084.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.72 / $146.24 / $270.17	Professional		$107.72	$146.24	$270.17
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $161.58 / $219.36 / $405.25	Professional	50	$161.58	$219.36	$405.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $185.28 / $226.68 / $74,999.25	Facility		$185.28	$226.68	$74,999.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $411.00 / $1,325.29 / $1,668.88	Facility		$411.00	$1,325.29	$1,668.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.74 / $198.49 / $390.47	Professional		$115.74	$198.49	$390.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.76 / $220.40 / $862.91	Professional		$123.76	$220.40	$862.91
United Facility/Professional Facility Modifier Low / Median / High Price $510.00 / $3,100.00 / $5,272.00	Facility		$510.00	$3,100.00	$5,272.00
United Facility/Professional Professional Modifier Low / Median / High Price $159.24 / $230.01 / $407.52	Professional		$159.24	$230.01	$407.52