Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.60 / $147.02 / $300.74	Facility		$29.60	$147.02	$300.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $25.68 / $36.54	Professional		$20.72	$25.68	$36.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $5.92 / $14.80 / $29.60	Professional		$5.92	$14.80	$29.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $18.43 / $26.64 / $31.11	Facility		$18.43	$26.64	$31.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $16.78 / $27.08	Professional		$14.00	$16.78	$27.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.60 / $35.52 / $41.76	Facility		$29.60	$35.52	$41.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.60 / $35.82 / $59.20	Professional		$29.60	$35.82	$59.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.23 / $23.03 / $53.69	Facility		$19.23	$23.03	$53.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.03 / $34.28 / $189.12	Professional		$15.03	$34.28	$189.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.28 / $16.28 / $16.28	Professional		$16.28	$16.28	$16.28
United Facility/Professional Professional Modifier Low / Median / High Price $12.43 / $22.90 / $45.07	Professional		$12.43	$22.90	$45.07