Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.89 / $282.42 / $5,634.00	Facility		$109.89	$282.42	$5,634.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.89 / $137.36 / $210.41	Professional		$109.89	$137.36	$210.41
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $172.76 / $204.47 / $210.41	Professional	50	$172.76	$204.47	$210.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.69 / $60.69 / $121.37	Professional		$60.69	$60.69	$121.37
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $182.06 / $182.06 / $215.34	Professional	50	$182.06	$182.06	$215.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $856.00 / $4,320.00 / $8,230.00	Facility		$856.00	$4,320.00	$8,230.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $113.65 / $153.10	Professional		$90.76	$113.65	$153.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $136.13 / $170.47 / $229.66	Professional	50	$136.13	$170.47	$229.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.65 / $138.65 / $207.98	Facility		$106.65	$138.65	$207.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $130.51 / $143.56 / $195.77	Professional		$130.51	$143.56	$195.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $112.44 / $192.65	Facility		$50.00	$112.44	$192.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.75 / $151.66 / $275.79	Professional		$107.75	$151.66	$275.79
United Facility/Professional Facility Modifier Low / Median / High Price $119.00 / $2,174.00 / $4,426.00	Facility		$119.00	$2,174.00	$4,426.00
United Facility/Professional Professional Modifier Low / Median / High Price $122.10 / $156.93 / $288.00	Professional		$122.10	$156.93	$288.00