Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $67.61 / $218.78	Facility		$28.84	$67.61	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.88 / $72.44	Professional		$25.12	$33.88	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.30 / $53.70	Professional		$19.95	$26.30	$53.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $45.71 / $64.57	Facility		$24.55	$45.71	$64.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $22.91 / $47.86	Professional		$18.62	$22.91	$47.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $30.20 / $54.95	Facility		$24.55	$30.20	$54.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $38.02	Professional		$24.55	$24.55	$38.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $66.07 / $114.82	Facility		$38.02	$66.07	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $45.71 / $57.54	Professional		$23.44	$45.71	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $53.70 / $199.53	Professional		$41.69	$53.70	$199.53
United Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $33.88 / $45.71	Facility		$21.88	$33.88	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $20.42 / $66.07	Professional		$15.85	$20.42	$66.07