Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,778.28 / $7,943.28 / $16,595.87	Facility		$1,778.28	$7,943.28	$16,595.87
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,890.45 / $3,890.45 / $3,890.45	Facility	22	$3,890.45	$3,890.45	$3,890.45
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $8,317.64 / $8,317.64 / $16,982.44	Facility	50	$8,317.64	$8,317.64	$16,982.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,584.89 / $4,265.80	Professional		$1,071.52	$1,584.89	$4,265.80
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $173.78 / $302.00 / $954.99	Professional	AS	$173.78	$302.00	$954.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $1,096.48 / $1,698.24	Professional		$147.91	$1,096.48	$1,698.24
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $302.00 / $537.03 / $562.34	Professional	AS	$302.00	$537.03	$562.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,888.44 / $30,902.95 / $34,673.69	Facility		$5,888.44	$30,902.95	$34,673.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,548.82 / $2,290.87	Professional		$1,258.93	$1,548.82	$2,290.87
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $177.83 / $213.80 / $323.59	Professional	AS	$177.83	$213.80	$323.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,548.82 / $2,041.74	Facility		$1,202.26	$1,548.82	$2,041.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,479.11 / $1,905.46	Professional		$1,230.27	$1,479.11	$1,905.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $2,187.76 / $2,187.76	Facility		$34.67	$2,187.76	$2,187.76
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Facility	22	$2,630.27	$2,630.27	$2,630.27
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility	54	$1,513.56	$1,513.56	$1,513.56
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	AS	$218.78	$218.78	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,454.71 / $9,549.93	Professional		$1,548.82	$2,454.71	$9,549.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $1,445.44	Professional		$32.36	$33.11	$1,445.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $6,760.83 / $35,481.34	Facility		$1,174.90	$6,760.83	$35,481.34
United Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,778.28 / $2,818.38	Professional		$1,174.90	$1,778.28	$2,818.38