Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $12.89 / $152.66 / $3,429.49	Facility		$12.89	$152.66	$3,429.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.97 / $14.01 / $27.34	Professional		$11.97	$14.01	$27.34
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.01 / $39.53 / $40.17	Professional	50	$17.01	$39.53	$40.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $5.99 / $6.81 / $7.04	Professional	52	$5.99	$6.81	$7.04
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $2.39 / $2.72 / $2.81	Professional	53	$2.39	$2.72	$2.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $11.34 / $20.01 / $20.01	Professional		$11.34	$20.01	$20.01
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $21.41 / $26.01 / $28.01	Professional	50	$21.41	$26.01	$28.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,013.00 / $8,584.00 / $11,253.00	Facility		$3,013.00	$8,584.00	$11,253.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.52 / $11.56 / $17.72	Professional		$9.52	$11.56	$17.72
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $14.30 / $17.34 / $26.58	Professional	50	$14.30	$17.34	$26.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.34 / $18.68 / $22.01	Facility		$13.34	$18.68	$22.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.34 / $17.34 / $22.01	Professional		$13.34	$17.34	$22.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.89 / $17.89 / $17.89	Facility		$17.89	$17.89	$17.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.31 / $16.78 / $24.14	Professional		$13.31	$16.78	$24.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $597.00 / $3,176.00	Facility		$50.00	$597.00	$3,176.00
United Facility/Professional Professional Modifier Low / Median / High Price $11.10 / $16.39 / $26.02	Professional		$11.10	$16.39	$26.02