Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $1,995.26 / $5,370.32	Facility		$213.80	$1,995.26	$5,370.32
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $85.11 / $147.91 / $257.04	Facility	53	$85.11	$147.91	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $316.23 / $776.25	Professional		$169.82	$316.23	$776.25
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $74.13 / $128.82 / $229.09	Professional	53	$74.13	$128.82	$229.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $194.98 / $251.19	Professional		$165.96	$194.98	$251.19
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $134.90 / $134.90 / $134.90	Professional	53	$134.90	$134.90	$134.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $4,466.84 / $8,317.64	Facility		$2,089.30	$4,466.84	$8,317.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $389.05 / $575.44	Professional		$213.80	$389.05	$575.44
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $77.62 / $177.83 / $354.81	Professional	53	$77.62	$177.83	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $147.91 / $239.88	Facility		$24.55	$147.91	$239.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $158.49 / $436.52	Professional		$41.69	$158.49	$436.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $660.69 / $758.58	Facility		$371.54	$660.69	$758.58
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	22	$446.68	$446.68	$446.68
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $295.12 / $295.12 / $295.12	Facility	52	$295.12	$295.12	$295.12
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	53	$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $537.03	Professional		$302.00	$302.00	$537.03
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $95.50 / $151.36 / $275.42	Professional	53	$95.50	$151.36	$275.42
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $3,467.37 / $4,466.84	Facility		$954.99	$3,467.37	$4,466.84
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $309.03 / $524.81	Professional		$177.83	$309.03	$524.81
United Facility/Professional Professional Modifier 53 Low / Median / High Price $173.78 / $173.78 / $173.78	Professional	53	$173.78	$173.78	$173.78