Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,305.69 / $7,061.14 / $13,706.96	Facility		$1,305.69	$7,061.14	$13,706.96
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $804.98 / $979.27 / $1,301.21	Facility	54	$804.98	$979.27	$1,301.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,141.10 / $1,319.21 / $2,504.58	Professional		$1,141.10	$1,319.21	$2,504.58
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $162.91 / $307.63 / $911.08	Professional	AS	$162.91	$307.63	$911.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,096.36 / $1,210.73 / $1,731.12	Professional		$1,096.36	$1,210.73	$1,731.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $9,271.00 / $27,601.41 / $34,155.00	Facility		$9,271.00	$27,601.41	$34,155.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,167.80 / $1,420.15 / $2,086.89	Professional		$1,167.80	$1,420.15	$2,086.89
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $163.49 / $198.82 / $292.16	Professional	AS	$163.49	$198.82	$292.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,186.99 / $1,602.44 / $1,958.53	Facility		$1,186.99	$1,602.44	$1,958.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,186.99 / $1,543.09 / $1,899.18	Professional		$1,186.99	$1,543.09	$1,899.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,455.37 / $1,455.37 / $1,708.36	Facility		$1,455.37	$1,455.37	$1,708.36
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,008.15 / $1,008.15 / $1,008.15	Facility	54	$1,008.15	$1,008.15	$1,008.15
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $900.13 / $900.13 / $900.13	Facility	62	$900.13	$900.13	$900.13
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $144.02 / $144.02 / $144.02	Facility	AS	$144.02	$144.02	$144.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,378.23 / $1,892.42 / $2,836.15	Professional		$1,378.23	$1,892.42	$2,836.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,543.09	Professional		$32.34	$32.34	$1,543.09
United Facility/Professional Facility Modifier Low / Median / High Price $1,168.00 / $6,186.00 / $35,462.00	Facility		$1,168.00	$6,186.00	$35,462.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,296.66 / $1,831.79 / $2,777.88	Professional		$1,296.66	$1,831.79	$2,777.88