Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $227.36 / $3,098.94 / $5,677.96	Facility		$227.36	$3,098.94	$5,677.96
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $85.48 / $113.68 / $159.10	Facility	52	$85.48	$113.68	$159.10
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $34.19 / $85.47 / $158.94	Facility	53	$34.19	$85.47	$158.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.95 / $282.91 / $543.94	Professional		$170.95	$282.91	$543.94
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $35.90 / $85.42 / $166.90	Professional	53	$35.90	$85.42	$166.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.58 / $206.83 / $248.37	Professional		$165.58	$206.83	$248.37
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $158.26 / $158.26 / $158.26	Professional	53	$158.26	$158.26	$158.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,749.00 / $4,353.00 / $8,052.00	Facility		$1,749.00	$4,353.00	$8,052.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.19 / $387.61 / $555.79	Professional		$214.19	$387.61	$555.79
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $82.86 / $152.05 / $227.86	Professional	53	$82.86	$152.05	$227.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.72 / $165.58 / $236.50	Facility		$21.72	$165.58	$236.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $304.26 / $425.96	Professional		$39.90	$304.26	$425.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.26 / $655.97 / $761.00	Facility		$243.26	$655.97	$761.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $194.61 / $194.61 / $194.61	Facility	52	$194.61	$194.61	$194.61
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.65 / $48.65 / $48.65	Facility	53	$48.65	$48.65	$48.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $301.45 / $628.04	Professional		$301.45	$301.45	$628.04
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $143.54 / $196.79 / $361.11	Professional	53	$143.54	$196.79	$361.11
United Facility/Professional Facility Modifier Low / Median / High Price $538.00 / $2,715.00 / $4,128.00	Facility		$538.00	$2,715.00	$4,128.00
United Facility/Professional Professional Modifier Low / Median / High Price $298.70 / $406.06 / $657.72	Professional		$298.70	$406.06	$657.72
United Facility/Professional Professional Modifier 53 Low / Median / High Price $172.50 / $172.50 / $172.50	Professional	53	$172.50	$172.50	$172.50