Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.84 / $1,581.32 / $5,320.00	Facility		$170.84	$1,581.32	$5,320.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $77.58 / $140.37 / $267.69	Facility	52	$77.58	$140.37	$267.69
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $34.17 / $107.07 / $230.92	Facility	53	$34.17	$107.07	$230.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.40 / $280.74 / $535.37	Professional		$169.40	$280.74	$535.37
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $34.96 / $81.76 / $164.80	Professional	53	$34.96	$81.76	$164.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.58 / $211.16 / $219.61	Professional		$165.58	$211.16	$219.61
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $91.21 / $91.21 / $91.21	Professional	53	$91.21	$91.21	$91.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,421.00 / $2,296.00 / $4,059.00	Facility		$1,421.00	$2,296.00	$4,059.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.87 / $331.70 / $388.10	Professional		$186.87	$331.70	$388.10
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $119.93 / $235.92 / $309.85	Professional	53	$119.93	$235.92	$309.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.72 / $168.93 / $252.92	Facility		$21.72	$168.93	$252.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.33 / $243.89 / $424.18	Professional		$41.33	$243.89	$424.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.26 / $243.26 / $243.26	Facility		$243.26	$243.26	$243.26
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 $240.60 / $301.45 / $540.99	Professional		$240.60	$301.45	$540.99
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $49.44 / $105.45 / $215.17	Professional	53	$49.44	$105.45	$215.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $330.92	Professional		$32.34	$32.34	$330.92
United Facility/Professional Facility Modifier Low / Median / High Price $334.00 / $790.00 / $2,410.00	Facility		$334.00	$790.00	$2,410.00
United Facility/Professional Professional Modifier Low / Median / High Price $305.64 / $462.27 / $637.35	Professional		$305.64	$462.27	$637.35
United Facility/Professional Professional Modifier 53 Low / Median / High Price $88.55 / $139.85 / $207.50	Professional	53	$88.55	$139.85	$207.50