Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.21 / $1,703.96 / $5,320.00	Facility		$174.21	$1,703.96	$5,320.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $77.70 / $140.51 / $267.69	Facility	52	$77.70	$140.51	$267.69
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $34.22 / $107.07 / $221.28	Facility	53	$34.22	$107.07	$221.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.11 / $287.52 / $535.37	Professional		$171.11	$287.52	$535.37
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $35.04 / $82.23 / $165.24	Professional	53	$35.04	$82.23	$165.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.74 / $211.53 / $233.53	Professional		$165.74	$211.53	$233.53
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $90.53 / $91.50 / $161.07	Professional	53	$90.53	$91.50	$161.07
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 $182.90 / $326.23 / $383.80	Professional		$182.90	$326.23	$383.80
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $120.43 / $236.39 / $311.08	Professional	53	$120.43	$236.39	$311.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $21.83 / $169.22 / $245.37	Facility		$21.83	$169.22	$245.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.41 / $245.37 / $424.59	Professional		$41.41	$245.37	$424.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.68 / $243.68 / $243.68	Facility		$243.68	$243.68	$243.68
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $194.94 / $194.94 / $194.94	Facility	52	$194.94	$194.94	$194.94
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.74 / $48.74 / $48.74	Facility	53	$48.74	$48.74	$48.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.34 / $301.75 / $542.03	Professional		$220.34	$301.75	$542.03
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $49.44 / $105.45 / $215.48	Professional	53	$49.44	$105.45	$215.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $253.50	Professional		$32.34	$32.34	$253.50
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 $306.29 / $471.33 / $645.90	Professional		$306.29	$471.33	$645.90
United Facility/Professional Professional Modifier 53 Low / Median / High Price $88.55 / $137.13 / $160.38	Professional	53	$88.55	$137.13	$160.38