Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $239.88 / $24,547.09	Facility		$87.10	$239.88	$24,547.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $87.10 / $117.49	Professional		$85.11	$87.10	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $128.82 / $190.55	Facility		$102.33	$128.82	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $128.82	Professional		$87.10	$87.10	$128.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $128.82	Facility		$85.11	$85.11	$128.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $131.83	Professional		$85.11	$85.11	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $109.65	Facility		$87.10	$87.10	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $102.33	Professional		$87.10	$87.10	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $165.96	Facility		$85.11	$85.11	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $91.20 / $95.50	Professional		$87.10	$91.20	$95.50