Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.38 / $379.65 / $2,838.40	Facility		$110.38	$379.65	$2,838.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $132.22	Professional		$108.47	$108.47	$132.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.28 / $109.28 / $109.28	Professional		$109.28	$109.28	$109.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $216.94 / $262.50	Facility		$108.47	$216.94	$262.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $154.02	Professional		$108.47	$108.47	$154.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $108.47 / $162.71	Facility		$108.47	$108.47	$162.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $135.59	Professional		$108.47	$108.47	$135.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.47 / $108.47 / $163.28	Facility		$108.47	$108.47	$163.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $108.47 / $192.09	Professional		$108.47	$108.47	$192.09
United Facility/Professional Professional Modifier Low / Median / High Price $108.47 / $120.75 / $144.88	Professional		$108.47	$120.75	$144.88