Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $136.04 / $1,651.91	Facility		$106.33	$136.04	$1,651.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $164.61	Professional		$106.33	$106.33	$164.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $106.33	Professional		$106.33	$106.33	$106.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.38 / $125.40 / $212.66	Facility		$120.38	$125.40	$212.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $135.57	Professional		$106.33	$106.33	$135.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $136.04 / $190.46	Facility		$106.33	$136.04	$190.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $111.65 / $155.26	Professional		$106.33	$111.65	$155.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $354.88 / $354.88	Facility		$106.33	$354.88	$354.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $106.33 / $185.36	Professional		$106.33	$106.33	$185.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $110.58 / $163.60 / $212.68	Professional		$110.58	$163.60	$212.68
United Facility/Professional Professional Modifier Low / Median / High Price $106.33 / $112.71 / $129.83	Professional		$106.33	$112.71	$129.83