Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $380.19 / $13,489.63	Facility		$173.78	$380.19	$13,489.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $208.93	Professional		$173.78	$173.78	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $263.03 / $380.19	Facility		$204.17	$263.03	$380.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $263.03	Professional		$173.78	$173.78	$263.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $257.04	Facility		$173.78	$173.78	$257.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $269.15	Professional		$173.78	$173.78	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $173.78 / $213.80	Facility		$104.71	$173.78	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $204.17	Professional		$173.78	$173.78	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $331.13	Facility		$173.78	$173.78	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $186.21 / $194.98	Professional		$173.78	$186.21	$194.98