Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $973.53 / $4,008.66 / $69,066.39	Facility		$973.53	$4,008.66	$69,066.39
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $188.85 / $194.71 / $246.43	Facility	53	$188.85	$194.71	$246.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $973.53 / $1,102.35 / $1,746.26	Professional		$973.53	$1,102.35	$1,746.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,073.04 / $1,073.04 / $1,073.04	Professional		$1,073.04	$1,073.04	$1,073.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,683.00 / $46,264.00 / $104,552.00	Facility		$10,683.00	$46,264.00	$104,552.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $872.78 / $1,026.80 / $1,475.44	Professional		$872.78	$1,026.80	$1,475.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $875.60 / $1,201.80 / $1,386.37	Facility		$875.60	$1,201.80	$1,386.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $858.43 / $1,150.19 / $1,373.49	Professional		$858.43	$1,150.19	$1,373.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,059.11 / $1,059.11 / $1,059.11	Facility		$1,059.11	$1,059.11	$1,059.11
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $206.47 / $206.47 / $206.47	Facility	53	$206.47	$206.47	$206.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $968.90 / $1,595.77 / $3,125.47	Professional		$968.90	$1,595.77	$3,125.47
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 $1,666.00 / $8,525.00 / $30,109.00	Facility		$1,666.00	$8,525.00	$30,109.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,118.38 / $1,718.36 / $2,331.46	Professional		$1,118.38	$1,718.36	$2,331.46