Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $279.11 / $394.94 / $2,747.00	Facility		$279.11	$394.94	$2,747.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $126.54 / $156.56 / $197.47	Facility	52	$126.54	$156.56	$197.47
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $189.80 / $234.84 / $296.20	Facility	54	$189.80	$234.84	$296.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.07 / $306.36 / $490.82	Professional		$253.07	$306.36	$490.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,041.00 / $2,067.00 / $2,978.00	Facility		$1,041.00	$2,067.00	$2,978.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.52 / $250.27 / $395.15	Professional		$199.52	$250.27	$395.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $279.30 / $398.52 / $459.72	Facility		$279.30	$398.52	$459.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $284.66 / $398.52 / $628.32	Professional		$284.66	$398.52	$628.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $312.24 / $523.77 / $523.77	Facility		$312.24	$523.77	$523.77
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $419.02 / $419.02 / $419.02	Facility	52	$419.02	$419.02	$419.02
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $366.64 / $366.64 / $366.64	Facility	54	$366.64	$366.64	$366.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $284.02 / $394.39 / $592.57	Professional		$284.02	$394.39	$592.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $408.41	Professional		$32.34	$32.34	$408.41
United Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $668.00 / $3,176.00	Facility		$50.00	$668.00	$3,176.00
United Facility/Professional Professional Modifier Low / Median / High Price $265.04 / $367.23 / $590.19	Professional		$265.04	$367.23	$590.19