Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $308.81 / $394.31 / $5,634.00	Facility		$308.81	$394.31	$5,634.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $231.61 / $242.26 / $406.34	Facility	54	$231.61	$242.26	$406.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $241.69 / $323.01 / $608.21	Professional		$241.69	$323.01	$608.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,138.73 / $1,138.73 / $1,161.50	Professional	50	$1,138.73	$1,138.73	$1,161.50
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $211.61 / $242.26 / $327.05	Professional	54	$211.61	$242.26	$327.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $304.55 / $405.05 / $480.87	Professional		$304.55	$405.05	$480.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $856.00 / $4,320.00 / $8,230.00	Facility		$856.00	$4,320.00	$8,230.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.37 / $294.52 / $418.23	Professional		$214.37	$294.52	$418.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $321.55 / $441.79 / $627.34	Professional	50	$321.55	$441.79	$627.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $307.45 / $399.70 / $622.61	Facility		$307.45	$399.70	$622.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $320.58 / $384.70 / $480.87	Professional		$320.58	$384.70	$480.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $172.79 / $172.79 / $204.82	Facility		$172.79	$172.79	$204.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $259.20 / $365.88 / $597.47	Professional		$259.20	$365.88	$597.47
United Facility/Professional Facility Modifier Low / Median / High Price $933.00 / $2,252.00 / $4,426.00	Facility		$933.00	$2,252.00	$4,426.00
United Facility/Professional Professional Modifier Low / Median / High Price $257.41 / $345.88 / $604.29	Professional		$257.41	$345.88	$604.29