Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $514.01 / $2,678.00 / $5,175.00	Facility		$514.01	$2,678.00	$5,175.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,042.61 / $3,042.61 / $3,042.61	Facility	50	$3,042.61	$3,042.61	$3,042.61
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $60.28 / $180.45 / $1,376.49	Facility	52	$60.28	$180.45	$1,376.49
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.11 / $62.58 / $96.48	Facility	53	$24.11	$62.58	$96.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.21 / $298.77 / $693.60	Professional		$104.21	$298.77	$693.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.85 / $194.26 / $533.14	Professional		$97.85	$194.26	$533.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.49 / $2,152.57 / $4,143.39	Facility		$759.49	$2,152.57	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.47 / $306.41 / $815.04	Professional		$140.47	$306.41	$815.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $122.30 / $147.78 / $234.99	Facility		$122.30	$147.78	$234.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $361.62 / $364.47 / $625.00	Professional		$361.62	$364.47	$625.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $419.77 / $419.77 / $419.77	Facility		$419.77	$419.77	$419.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.88 / $309.30 / $825.78	Professional		$146.88	$309.30	$825.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $115.09 / $327.23 / $1,566.00	Professional		$115.09	$327.23	$1,566.00
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $73.13 / $73.13 / $207.91	Professional	52	$73.13	$73.13	$207.91
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $73.13 / $73.13 / $207.91	Professional	53	$73.13	$73.13	$207.91
United Facility/Professional Facility Modifier Low / Median / High Price $424.00 / $2,360.00 / $4,066.00	Facility		$424.00	$2,360.00	$4,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $318.89 / $558.83 / $1,076.96	Professional		$318.89	$558.83	$1,076.96