Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,035.00 / $8,874.25 / $25,075.84	Facility		$2,035.00	$8,874.25	$25,075.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,798.00 / $6,798.00 / $20,198.00	Facility	50	$6,798.00	$6,798.00	$20,198.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $812.78 / $812.78 / $1,156.28	Facility	54	$812.78	$812.78	$1,156.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,083.70 / $1,510.81 / $6,153.00	Professional		$1,083.70	$1,510.81	$6,153.00
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $160.11 / $238.37 / $911.08	Professional	AS	$160.11	$238.37	$911.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,126.63 / $1,542.36 / $1,845.82	Professional		$1,126.63	$1,542.36	$1,845.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,232.00 / $8,571.00 / $24,787.00	Facility		$2,232.00	$8,571.00	$24,787.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,421.76 / $1,847.33 / $2,676.13	Professional		$1,421.76	$1,847.33	$2,676.13
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $198.82 / $258.97 / $374.65	Professional	AS	$198.82	$258.97	$374.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,661.00 / $16,144.00 / $21,281.00	Facility		$9,661.00	$16,144.00	$21,281.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,281.31 / $1,834.05 / $2,968.53	Professional		$1,281.31	$1,834.05	$2,968.53
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,220.35 / $2,160.66 / $25,000.00	Facility		$1,220.35	$2,160.66	$25,000.00
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $2,273.19 / $2,273.19 / $35,560.28	Facility	54	$2,273.19	$2,273.19	$35,560.28
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $2,029.64 / $2,029.64 / $31,750.25	Facility	62	$2,029.64	$2,029.64	$31,750.25
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $324.74 / $324.74 / $5,080.04	Facility	AS	$324.74	$324.74	$5,080.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,362.09 / $1,912.94 / $13,550.61	Professional		$1,362.09	$1,912.94	$13,550.61
Medica Facility/Professional Professional Modifier AS Low / Median / High Price $282.14 / $282.14 / $282.14	Professional	AS	$282.14	$282.14	$282.14
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $2,100.67 / $2,100.67 / $2,100.67	Professional		$2,100.67	$2,100.67	$2,100.67
United Facility/Professional Facility Modifier Low / Median / High Price $2,695.00 / $6,250.00 / $34,144.00	Facility		$2,695.00	$6,250.00	$34,144.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.79 / $1,724.93 / $2,931.95	Professional		$1,288.79	$1,724.93	$2,931.95