Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,688.00 / $5,794.50 / $13,855.00	Facility		$1,688.00	$5,794.50	$13,855.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,676.63 / $10,676.63 / $24,076.80	Facility	50	$10,676.63	$10,676.63	$24,076.80
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,225.25 / $1,372.19 / $1,572.35	Facility	54	$1,225.25	$1,372.19	$1,572.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,158.09 / $1,409.17 / $2,142.71	Professional		$1,158.09	$1,409.17	$2,142.71
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $227.83 / $293.18 / $594.04	Professional	AS	$227.83	$293.18	$594.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $268.06 / $1,824.60 / $2,153.51	Professional		$268.06	$1,824.60	$2,153.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $13,270.34 / $13,270.34 / $15,924.41	Facility		$13,270.34	$13,270.34	$15,924.41
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,349.09 / $1,686.37 / $1,785.56	Professional		$1,349.09	$1,686.37	$1,785.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,522.29 / $1,659.78 / $4,967.47	Facility		$1,522.29	$1,659.78	$4,967.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,481.95 / $1,481.95 / $1,541.23	Professional		$1,481.95	$1,481.95	$1,541.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,469.53 / $2,266.32 / $2,604.21	Professional		$1,469.53	$2,266.32	$2,604.21
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $308.27 / $2,201.91 / $2,476.54	Professional		$308.27	$2,201.91	$2,476.54
United Facility/Professional Facility Modifier Low / Median / High Price $2,896.00 / $5,749.00 / $12,000.00	Facility		$2,896.00	$5,749.00	$12,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,269.54 / $1,807.92 / $2,542.57	Professional		$1,269.54	$1,807.92	$2,542.57