Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.01 / $184.47 / $2,747.00	Facility		$113.01	$184.47	$2,747.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.71 / $155.68 / $217.90	Professional		$103.71	$155.68	$217.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $383.48 / $643.88 / $643.88	Professional	50	$383.48	$643.88	$643.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $209.63 / $209.63 / $209.63	Professional		$209.63	$209.63	$209.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,041.00 / $2,067.00 / $2,978.00	Facility		$1,041.00	$2,067.00	$2,978.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.34 / $134.94 / $229.06	Professional		$85.34	$134.94	$229.06
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $128.01 / $202.43 / $340.14	Professional	50	$128.01	$202.43	$340.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.03 / $153.76 / $177.38	Facility		$112.03	$153.76	$177.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.83 / $159.25 / $335.40	Professional		$109.83	$159.25	$335.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.22 / $202.09 / $202.09	Facility		$162.22	$202.09	$202.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.76 / $190.32 / $357.53	Professional		$118.76	$190.32	$357.53
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 $154.24 / $218.83 / $358.11	Professional		$154.24	$218.83	$358.11