Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $79.43	Facility		$75.86	$75.86	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $128.82	Professional		$61.66	$75.86	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $120.23	Professional		$109.65	$109.65	$120.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $151.36 / $158.49	Facility		$134.90	$151.36	$158.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $44.67 / $46.77	Professional		$28.18	$44.67	$46.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $208.93 / $53,703.18	Facility		$112.20	$208.93	$53,703.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $186.21 / $239.88	Professional		$147.91	$186.21	$239.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $234.42 / $234.42	Facility		$83.18	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $173.78 / $707.95	Professional		$61.66	$173.78	$707.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $147.91	Professional		$114.82	$114.82	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $72.44 / $83.18	Facility		$66.07	$72.44	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $70.79 / $102.33	Professional		$48.98	$70.79	$102.33